Dr. Rabinovitch

The applicant, an intercity bus driver, was injured in a motor vehicle accident and sought post-104 income replacement benefits (IRBs).

The respondent denied the benefits, arguing the applicant's return to part-time work as a mail courier demonstrated she did not suffer a complete inability to engage in suitable employment.

The Tribunal found that the applicant's cognitive decline, photophobia, and reduced stamina rendered her unable to perform the highly responsible duties of an intercity bus driver.

Relying on the applicant's recent neurological and neuropsychological assessments, the Tribunal concluded her condition had deteriorated over time and she met the post-104 test as of September 27, 2023.

The applicant was awarded IRBs from that date onward, plus interest.

The applicant, who sustained a catastrophic impairment in a 2017 motor vehicle accident, sought attendant care benefits (ACBs) and various medical and rehabilitation benefits.

The Tribunal found the applicant entitled to ACBs for specific periods based on his psychological impairments, but held the benefits were not payable because the applicant failed to prove they were incurred.

The Tribunal partially approved treatment plans for social work, aquatherapy, concussion treatment, and a home renovation assessment, while denying others that were reasonably available through OHIP.

The Tribunal ordered Aviva to pay a special award of $9,041.12 under s. 10 of Regulation 664, finding that the insurer acted unreasonably and in bad faith by pre-emptively denying treatment plans and failing to comply with procedural timelines.

The applicant sought statutory accident benefits following a motor vehicle accident, including post-104-week income replacement benefits (IRBs) and various treatment plans.

The respondent denied the benefits.

The Tribunal found that the applicant demonstrated a complete inability to engage in any employment for which she was reasonably suited by education, training, or experience, primarily due to chronic pain syndrome and psychological impairments.

The Tribunal awarded IRBs from June 23, 2023, ongoing.

The Tribunal also approved treatment plans for psychological therapy, Botox for migraines, psychological assessments, and a chronic pain program, finding them reasonable and necessary.

However, the Tribunal denied several physical therapy, chiropractic, and assistive device plans, noting a lack of physical improvement from prior physical treatments.

The claim for a special award was dismissed, but interest was awarded on overdue benefits.

The applicant sought income replacement benefits, medical benefits, interest, and a special award following a motor vehicle accident.

The Licence Appeal Tribunal dismissed all claims.

The Tribunal found the applicant failed to prove a substantial inability to perform the essential tasks of his employment, noting inconsistencies in his medical records, a failure to report pre-accident income, and persuasive insurer examination reports.

The claims for chiropractic, psychological, and occupational therapy treatment plans were also dismissed because the applicant failed to submit the plans into evidence and did not establish that the treatments were reasonable and necessary.

The applicant sought entitlement to statutory accident benefits for an occupational therapy assessment and treatment plan following a 2018 motor vehicle accident.

The adjudicator found that the applicant failed to prove the treatment plans were reasonable and necessary, noting that medical evidence and the applicant's own self-reports indicated she was independent in her activities of daily living, had resumed driving, and was working.

As no benefits were payable, the claims for interest and a special award were also dismissed.

The applicant sought medical and rehabilitation benefits following a motor vehicle accident.

The insurer denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant failed to provide compelling medical evidence of chronic pain, psychological impairment, or a pre-existing condition that would warrant removal from the MIG.

As the $3,500 MIG limit was already exhausted, all disputed treatment plans and the claim for interest were denied.

The applicant sought an income replacement benefit (IRB) following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding the applicant procedurally disentitled due to his failure to comply with section 33 of the Schedule and document production orders regarding his financial and employment records.

Furthermore, the Tribunal found the applicant failed to substantively establish a substantial inability to perform the essential tasks of his employment within 104 weeks of the accident, or a complete inability to engage in suitable employment thereafter.

Claims for an award and interest were also dismissed.

The applicant sought entitlement to a physiatry assessment, a special award, and interest under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The respondent insurer denied the assessment based on its own section 44 physiatry assessment and the applicant's failure to provide requested medical records.

The Tribunal found the physiatry assessment was reasonable and necessary based on the medical evidence, but held the insurer was not liable to pay until the applicant cured her section 33 non-compliance by providing the requested records.

The claim for a special award was dismissed as the insurer's denial was based on a rational assessment of the available information and did not constitute unreasonable conduct.

The applicant was injured in a motor vehicle accident and deemed catastrophically impaired.

They sought various statutory accident benefits, including attendant care benefits, medical and rehabilitation expenses, and an award for unreasonable delay.

The Licence Appeal Tribunal found the applicant entitled to a reduced amount of attendant care benefits, case management services, and chiropractic treatment, as the insurer had previously approved or partially approved these amounts.

The remaining claims for assessments, assistive devices, and other treatments were dismissed for lack of medical evidence proving they were reasonable and necessary.

The Tribunal declined to make an award under section 10 of Regulation 664, finding the insurer did not unreasonably withhold or delay payments.

The applicant sought income replacement benefits (IRBs) following a motor vehicle accident, claiming a substantial inability to perform the essential tasks of his pre-accident self-employment in renovation and landscaping.

The Tribunal found that the applicant failed to provide objective medical evidence demonstrating that his accident-related impairments prevented him from working.

The medical evidence primarily showed minor contusions and soft tissue injuries, and an insurer's examination concluded he did not suffer a substantial inability to work.

The application for IRBs, interest, and an award was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming chronic pain, post-traumatic fibromyalgia, and sleep disorder to escape the Minor Injury Guideline (MIG).

The adjudicator found the applicant's evidence of functional limitations and pain severity to be vague, inconsistent, and contradicted by his family doctor's records.

The adjudicator rejected the applicant's expert opinion and concluded the injuries were predominantly minor soft tissue injuries subject to the MIG.

As the $3,500 MIG limit was exhausted, the claimed medical and assessment benefits were denied.

The respondent's request for costs was also dismissed.