Dr. P. Tepperman

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for a functional cognitive test battery and a chronic pain assessment, which the respondent insurer denied.

The Licence Appeal Tribunal found that the applicant's pre-existing chronic pain was exacerbated by the accident, making the chronic pain assessment reasonable and necessary.

However, the Tribunal denied the functional cognitive test battery, finding no evidence of a cognitive deficit unrelated to the applicant's psychological impairments.

The Tribunal also denied the applicant's request for an award under Regulation 664, as the insurer's reliance on its independent medical examinations was not unreasonable.

The applicant sought statutory accident benefits following a 2017 motor vehicle accident, disputing the respondent's denial of an ongoing income replacement benefit (IRB), a chronic pain assessment, and psychological services.

The Licence Appeal Tribunal dismissed the claim for ongoing IRB, finding the applicant failed to prove a substantial inability to perform the essential tasks of his employment, relying on a psychological reassessment indicating his driving anxiety had improved.

The Tribunal also denied the disputed psychological services due to a lack of evidence challenging the respondent's partial approval.

However, the Tribunal granted the $2,000 chronic pain assessment, finding it reasonable and necessary given the applicant's consistent pain reporting and objective evidence of meralgia paresthetica.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for a chiropractic treatment plan, a psychological assessment, and a psychological treatment plan.

The respondent partially denied funding for these plans.

The Tribunal found that the chiropractic treatment plan was not reasonable and necessary, but the applicant was entitled to some incurred expenses because the respondent failed to provide a valid medical reason for the denial within the required timeframe.

The Tribunal also found the applicant was entitled to the unpaid balance of the psychological assessment because the respondent's denial was not clear and unequivocal.

The balance of the psychological treatment plan was denied as it was not reasonable and necessary, and the psychotherapist was not entitled to the same hourly rate as a psychologist.

Interest was awarded on the overdue payments.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the insurer's denial of two chiropractic treatment plans, interest, and an award for unreasonable withholding.

The Tribunal found the October 2017 treatment plan reasonable and necessary based on timely medical records and psychological assessments, but dismissed the May 2018 plan due to a lack of persuasive evidence and an uncontested insurer examination finding symptom magnification.

The applicant was awarded interest on the approved plan but denied a special award, as the insurer had responded to the plans within the required timelines and provided valid medical reasons.

The applicant was injured in a motor vehicle accident and received statutory accident benefits.

The insurer terminated weekly income benefits, and the applicant sought ongoing income benefits, supplementary medical and rehabilitation benefits, care benefits, and a special award.

The insurer claimed a repayment of overpaid benefits due to an alleged calculation error and the applicant's receipt of CPP disability benefits.

The arbitrator found that the applicant failed to establish that her ongoing back problems were caused by the accident, given her pre-existing degenerative disc disease and prior injuries.

Consequently, claims for ongoing income, medical, and care benefits were dismissed.

The arbitrator determined the correct weekly income benefit rate and ordered the applicant to repay $16,540.54 for overlapping CPP benefits, but denied the insurer's claim for repayment based on 'error,' finding the insurer had deliberately chosen its calculation method.

The applicant's claims for a special award and arbitration expenses were dismissed.