Dr. Raymond Zabieliauskas

The applicant sought a determination of catastrophic impairment (CAT) under Criterion 8 (mental and behavioural disorders) and entitlement to post-104-week income replacement benefits (IRBs) following a motor vehicle accident.

The Tribunal found that the applicant's psychological and physical impairments were primarily caused by a pre-existing slip and fall incident, not the motor vehicle accident.

The Tribunal noted significant credibility issues, including surveillance footage and evidence of the applicant's ongoing involvement in complex real estate and construction projects, which contradicted his reported functional limitations.

The application was dismissed, and claims for an award and interest were denied.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the insurer's determination that her injuries fell within the Minor Injury Guideline (MIG).

The applicant argued she suffered from chronic pain and a psychological disorder warranting removal from the MIG.

The Tribunal found the applicant's evidence of pain insufficient to establish functional impairment, preferring the respondent's physiatry assessment.

The Tribunal also accepted the respondent's psychological assessment, which found evidence of malingering and no diagnosable psychological injury.

As the injuries were predominantly minor and the MIG limits were exhausted, the claims for treatment plans, an award, interest, and costs were dismissed.

The applicant sought entitlement to statutory accident benefits for chiropractic and physiotherapy treatment plans following a 2018 motor vehicle accident.

The adjudicator found that the claim for the first treatment plan had already been resolved by agreement between the parties.

For the remaining treatment plans, the adjudicator preferred the evidence of the respondent's insurer's examination assessors, who concluded that the applicant had fully recovered from minor soft tissue injuries and did not require further facility-based treatment.

The application was dismissed, and claims for interest and a special award were denied.

The applicant was involved in a motor vehicle accident and sought a determination of catastrophic impairment and entitlement to income replacement benefits (IRBs) and a treatment plan.

The Tribunal found the applicant sustained a catastrophic impairment under Criterion 8 due to marked impairments in social functioning, concentration, persistence and pace, and adaptation resulting from accident-related psychological disorders.

The Tribunal denied the applicant's claim for IRBs during the first 104 weeks post-accident, finding she did not suffer a substantial inability to perform the essential tasks of her employment.

However, the Tribunal granted IRBs from September 1, 2024 onward, finding her condition had deteriorated such that she suffered a complete inability to engage in any employment for which she was reasonably suited.

The claim for a second catastrophic assessment treatment plan was denied.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent denied several treatment and assessment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant suffered from chronic pain with functional impairments, removing her from the MIG.

The Tribunal ordered the respondent to pay for the disputed physiotherapy, psychological, and chronic pain treatment plans, finding them reasonable and necessary.

The applicant's claim for a special award for unreasonable delay was dismissed, but interest on overdue benefits was granted.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to non-earner benefits, various treatment plans, and removal from the Minor Injury Guideline (MIG) due to chronic pain, psychological impairments, and pre-existing conditions.

The adjudicator found that the applicant did not suffer a complete inability to carry on a normal life, relying on inconsistencies in the medical records and evidence of the applicant's ability to perform activities of daily living.

The adjudicator also declined to remove the applicant from the MIG, preferring the respondent's psychological assessment which indicated malingering, and finding insufficient evidence of chronic pain with functional impairment.

As the MIG limits were exhausted, the claims for treatment plans, an award, and interest were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent denied various treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit had been exhausted.

The applicant argued for removal from the MIG due to psychological impairment and chronic pain.

The Tribunal preferred the evidence of the insurer's assessors, finding no psychiatric diagnosis or chronic pain attributable to the accident.

The Tribunal concluded the injuries were predominantly minor, the MIG limit applied, and dismissed the claims for further treatment, interest, and an award for unreasonable delay.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits from the respondent insurer.

The Licence Appeal Tribunal considered whether the applicant was entitled to pre-104 week and post-104 week income replacement benefits (IRBs), various treatment plans, interest, and a special award.

The Tribunal found that the applicant, a self-employed massage therapist, suffered a substantial inability to perform the essential tasks of her employment and was entitled to pre-104 week IRBs.

However, the Tribunal rejected the applicant's claim that her self-employment income was $30,000, finding the supporting documentation unreliable, and instead calculated the IRBs at $169.00 per week based on her originally declared income.

The applicant failed to establish entitlement to post-104 week IRBs.

The Tribunal approved several treatment plans, including occupational therapy, rehabilitation support worker sessions, psychotherapy, an attendant care assessment, and a rollator walker, finding them reasonable and necessary based on the medical evidence, including supportive reports from the respondent's own occupational therapy assessor.

Other treatment plans were denied for lack of evidence.

The Tribunal awarded interest on overdue payments but denied the request for a special award, concluding the insurer's reliance on its own medical reports was not unreasonable.

The applicant sought various statutory accident benefits following a motor vehicle accident.

The respondent initially denied several treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

After the applicant was removed from the MIG, the respondent failed to provide updated denial notices with medical reasons for several treatment plans.

The Tribunal applied the Divisional Court's decision in Suarez, holding that the defective notices could not be cured, and ordered those treatment plans payable once incurred.

The Tribunal also evaluated the substantive reasonableness and necessity of the remaining treatment plans, granting entitlement to psychological and occupational therapy based on the applicant's exacerbated pre-existing conditions, while denying further physical therapy and neurological assessments.

The claim for a special award was dismissed as the insurer's reliance on its assessors was not unreasonable.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits.

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

The applicant applied to the Tribunal, claiming she should be removed from the MIG due to chronic pain with functional impairment and a psychological condition.

The Tribunal found that the applicant failed to provide compelling medical evidence to support removal from the MIG.

The Tribunal preferred the comprehensive s. 44 assessments provided by the respondent's experts over the applicant's OCF-18s, which were completed to secure funding.

As the applicant remained within the MIG, the disputed treatment plans were not considered, and claims for an award and interest were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including six chiropractic treatment plans, an attendant care needs assessment, and an orthopaedic assessment.

The respondent denied the benefits, relying on insurer's examinations which concluded the applicant's injuries were minor and had resolved, and that her ongoing complaints stemmed from pre-existing osteoarthritis.

The Tribunal found that the chiropractic treatment plans and attendant care needs assessment were not reasonable and necessary, preferring the respondent's physiatrist's reports over the applicant's orthopaedic surgeon's report.

However, the Tribunal granted the orthopaedic assessment, finding that the family doctor's clinical notes corroborated an aggravation of the applicant's pre-existing knee condition caused by the accident.

The Tribunal also found the respondent's denial notices compliant with the Schedule and declined to order a special award.

The applicant sought statutory accident benefits following a 2017 motor vehicle accident.

The respondent denied treatment plans for a neuro-optometric assessment, prolotherapy, and psychological services.

The Tribunal found the neuro-optometric assessment was not reasonable and necessary, as the supporting medical reports were either not contemporaneous or did not recommend further assessments.

The Tribunal approved the prolotherapy plan, preferring the in-person assessment of the applicant's physiatrist over the respondent's remote assessment.

The claim for the balance of psychological services was dismissed, as the applicant failed to justify the need for an updated assessment or the higher hourly rate for a psychotherapist.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to treatment plans for physiotherapy, psychological services, and chronic pain assessments outside the Minor Injury Guideline (MIG).

The respondent insurer denied the benefits, arguing the injuries were predominantly minor.

The Tribunal found that the applicant failed to prove on a balance of probabilities that he suffered from chronic pain or a psychological impairment warranting removal from the MIG.

The Tribunal preferred the evidence of the respondent's section 44 assessors, noting the lack of objective medical evidence, the absence of complaints to family doctors, and Facebook posts showing the applicant performing physical activities without apparent discomfort.

The application was dismissed, and the applicant was limited to the remaining MIG funding.

The court ruled on a threshold motion and costs following a jury trial in a motor vehicle accident case.

The defendant conceded liability, but after the jury awarded no damages, the defendant moved for a declaration that the plaintiff’s injuries did not meet the statutory threshold for health care expenses and non-pecuniary damages under the Insurance Act and regulations.

The court found that while the plaintiff suffered a permanent impairment, it was not serious or important enough to meet the threshold.

The defendant was awarded $150,000 in costs.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the respondent's determination that his injuries fell within the Minor Injury Guideline (MIG).

The applicant argued he suffered from chronic pain and psychological impairments warranting removal from the MIG, relying on reports from an orthopaedic surgeon and a psychologist.

The Tribunal found the applicant did not provide compelling medical evidence to support a diagnosis of chronic pain or psychological impairment, noting that the family physician's records indicated the accident-related issues had resolved.

As the applicant's injuries were predominantly minor and the $3,500 MIG limit had been exhausted, the claims for additional treatment plans and interest were dismissed.

The Applicant sought entitlement to a treatment plan for physiotherapy services in the amount of $4,115.12, along with an award and interest, following a motor vehicle accident.

The Respondent denied the benefits.

The Tribunal found that the Applicant failed to meet her burden of proving the treatment plan was reasonable and necessary, noting a lack of contemporaneous or compelling medical evidence supporting the need for physical therapy.

The Tribunal preferred the comprehensive assessment of the Respondent's section 44 assessor over the Applicant's medical reports.

The application was dismissed, and claims for an award and interest were consequently denied.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent denied certain treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant applied to the Licence Appeal Tribunal, arguing he should be removed from the MIG due to psychological impairments and chronic pain.

The Tribunal found the applicant's evidence of psychological impairment and chronic pain to be underwhelming and unsupported by contemporaneous medical records.

The Tribunal preferred the evidence of the respondent's section 44 assessors, who concluded the applicant suffered only minor soft tissue injuries with no functional limitations.

The Tribunal held the applicant remained within the MIG, dismissed the claims for the treatment plans and interest, and declined to award costs.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to a chronic pain assessment and removal from the Minor Injury Guideline (MIG).

The respondent denied the benefits, arguing the applicant's injuries were predominantly minor and the MIG limit had been exhausted.

The Tribunal found that the applicant failed to establish that her accident-related soft tissue injuries caused functional impairment or met the criteria for chronic pain syndrome under the AMA Guides.

The Tribunal concluded the injuries were predominantly minor, dismissed the claim for the chronic pain assessment, and denied claims for an award and interest.

The applicant sought accident benefits following a motor vehicle accident, which the respondent denied on the basis that the injuries fell within the Minor Injury Guideline (MIG).

The applicant sought removal from the MIG due to physical and psychological impairments, as well as entitlement to non-earner benefits (NEBs) and specific treatment plans.

The Tribunal found that the applicant's physical and psychological injuries were minor and did not warrant removal from the MIG.

Relying on medical assessments and surveillance evidence showing the applicant working and driving, the Tribunal concluded the applicant did not suffer a complete inability to carry on a normal life.

The application for NEBs, treatment plans, an award, and interest was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent denied income replacement benefits and several treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline.

The Tribunal found the applicant was not entitled to income replacement benefits or the disputed treatment plans, as he failed to provide sufficient evidence or submissions to challenge the respondent's section 44 assessments.

Although the respondent failed to respond to one treatment plan within the required 10 business days, no amounts were owing as the treatment had not been incurred.

The claims for an award and interest were dismissed.