Dr. Raymond Zabieliauskas

The applicant sought payment for chiropractic, occupational therapy, and social work treatment plans following a motor vehicle accident.

The respondent insurer denied the plans based on insurer's examinations concluding the applicant had no accident-related impairments.

The Tribunal found that the applicant failed to meet his onus to prove the treatments were reasonable and necessary, noting a lack of contemporaneous medical evidence and failure to disclose medical records.

The application for accident benefits was dismissed.

The applicant sought various statutory accident benefits after being struck by a detached tire while walking.

The Licence Appeal Tribunal dismissed the application in its entirety, finding that the applicant had fully recovered from his physical injuries and was engaging in 'learned helplessness'.

The Tribunal denied claims for attendant care, assistive devices, occupational therapy, and chiropractic treatments, noting inconsistencies in the applicant's expert evidence and exaggerated assessment fees.

The claim for non-earner benefits was dismissed as time-barred and substantively unproven.

Claims for a special award and interest were also dismissed.

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

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

The Tribunal found that the applicant's physical injuries were predominantly minor soft tissue injuries that had resolved, and she failed to provide compelling evidence that pre-existing conditions or chronic pain warranted removal from the MIG.

The Tribunal also rejected the applicant's psychological claims, finding her depression and anxiety were caused by her husband's terminal illness and death, not the accident.

As the MIG limit was exhausted, all claims for treatment plans, medication, interest, and a section 10 award were dismissed.

The applicant sought statutory accident benefits for physiotherapy, an in-home functional assessment, and a psychological assessment following a motor vehicle accident.

The insurer denied the treatment plans, arguing the applicant's impairments were a natural progression of pre-existing conditions.

The Tribunal found that the accident aggravated the applicant's pre-existing physical and psychological impairments, making the proposed treatment plans reasonable and necessary.

The Tribunal ordered the insurer to pay for the treatment plans with interest, but declined to order a special award under section 10 of Regulation 664, finding the insurer's initial denial was not unreasonable based on the medical evidence it had at the time.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming she sustained a concussion, psychological injuries, and exacerbation of a pre-existing condition that warranted removal from the Minor Injury Guideline (MIG).

The respondent denied the claims, relying on insurer examinations which concluded the injuries were predominantly minor.

The Tribunal found the applicant failed to provide sufficient medical evidence, such as a formal diagnosis or neurological testing, to prove she suffered a concussion or other non-minor injuries.

The Tribunal concluded the applicant's injuries fell within the MIG, dismissing her claims for treatment plans outside the $3,500 limit, interest, and a special award.

The applicant sought a non-earner benefit (NEB), interest, and an award following a motor vehicle accident.

As a preliminary matter, the Tribunal struck the applicant's written submissions beyond the 10-page limit set by a prior case conference order.

The Tribunal allowed the applicant to add a claim for an award to the issues in dispute.

On the merits, the Tribunal found the applicant failed to meet the evidentiary burden under the Heath test to prove a complete inability to carry on a normal life, relying instead on vague submissions and insufficient OCF-3 certificates.

The Tribunal preferred the respondent's medical evidence that the applicant had resumed his pre-accident life.

The claims for NEB, interest, and an award were dismissed.

The applicant was injured in a rear-end motor vehicle accident and sought statutory accident benefits, including income replacement benefits (IRBs) and medical benefits.

The Licence Appeal Tribunal found that the applicant's accident-related psychological condition and pain caused a substantial inability to perform the essential tasks of her pre-accident employment as a student placement coordinator, entitling her to IRBs for the pre-104 week period.

However, the Tribunal dismissed her claim for post-104 week IRBs, finding she did not suffer a complete inability to engage in suitable employment.

The Tribunal also denied the claimed medical benefits for physiotherapy, an attendant care assessment, and assistive devices, preferring the insurer's medical evidence that the physical injuries did not warrant the disputed treatment plans.

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

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

The Tribunal found that the applicant's physical injuries were predominantly soft-tissue in nature, supported by normal diagnostic imaging.

The Tribunal also rejected the applicant's claim of psychological impairment, preferring the respondent's in-person psychological assessment over the applicant's telephone-based assessment.

As the applicant failed to prove his injuries warranted removal from the MIG, the disputed treatment plans exceeding the $3,500 limit were not payable.

The applicant sought statutory accident benefits following two motor vehicle accidents.

The adjudicator held that the applicant was precluded from claiming an income replacement benefit for the second accident because he had elected to receive a non-earner benefit, an election that is final under s. 35(3) of the Schedule.

For the first accident, the applicant failed to prove a complete inability to engage in employment to qualify for a post-104 income replacement benefit.

Furthermore, the adjudicator found that the applicant's injuries from both accidents fell within the Minor Injury Guideline, as he failed to demonstrate that pre-existing conditions, chronic pain, or psychological impairments prevented him from achieving maximum medical recovery within the guideline's limits.

All claims were dismissed.

The applicant sought medical benefits for three chiropractic treatment plans following a motor vehicle accident.

The respondent denied the plans, relying in part on an insurer's examination report.

The Tribunal found that the respondent's denial notices failed to comply with section 38(8) of the Statutory Accident Benefits Schedule because they lacked specific medical reasons and relied on an examination report that did not address the specific treatment plans in dispute.

As a result of the defective notices, the respondent was ordered to pay for the treatment plans pursuant to section 38(11).

The Tribunal also awarded interest on the overdue benefits and a 25% special award due to the respondent's unreasonable delay and failure to properly adjust the file.

The applicant sought statutory accident benefits following a motor vehicle accident while a passenger on a transit bus.

The respondent insurer denied the claims, asserting the injuries fell within the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG based on psychological impairments and chronic pain.

The Tribunal found the applicant's injuries were predominantly soft-tissue strains, relying on clinical notes and the insurer's examination.

The Tribunal concluded the applicant failed to provide persuasive medical evidence of a psychological injury or chronic pain syndrome that would warrant removal from the MIG.

Consequently, the disputed treatment plans exceeding the $3,500 limit were not payable, and the application was dismissed.

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

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

The Tribunal found the applicant's injuries, specifically fragmentation of the lateral distal tibia, warranted removal from the MIG.

The Tribunal granted the claim for an orthopaedic assessment, finding it reasonable and necessary based on objective evidence of physical complaints and a pre-existing knee injury.

However, claims for physiotherapy were dismissed due to a lack of evidentiary submissions, and a psychological assessment was denied after the applicant's psychological report was excluded for late production.

Interest was awarded on the approved orthopaedic assessment.

The applicant was injured in a motor vehicle accident and sought various treatment plans for physiotherapy and assessments under the Statutory Accident Benefits Schedule.

The respondent denied the plans.

The Tribunal found the applicant was entitled to a physiotherapy treatment plan of $2,418.00, a functional impairment assessment of $1,988.80, and a physiatry assessment of $2,000.00, noting the respondent failed to provide proper medical reasons for denying the assessments under s. 38(8) of the Schedule.

The Tribunal denied the remaining physiotherapy treatment plans, finding them not reasonable and necessary based on the insurer's examination reports.

The claim for an award under Regulation 664 was dismissed, but interest was awarded on overdue benefits.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for chiropractic and physiotherapy treatment plans, which the respondent insurer denied.

The adjudicator found that the medical evidence, including clinical notes and psychological assessments, demonstrated the applicant continued to experience accident-related pain and physical impairments.

The respondent's reliance on a three-year-old physiatry assessment and speculation about life events causing the pain were rejected.

The Tribunal concluded the treatment plans were reasonable and necessary to provide pain relief and improve functionality, granting the application in its entirety with interest.

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

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

The Tribunal found that the applicant's injuries were not predominantly minor due to chronic pain, removing her from the MIG.

However, the Tribunal dismissed the claims for the disputed treatment plans, finding that the applicant failed to prove on a balance of probabilities that the chiropractic treatments and psychological assessment were reasonable and necessary.

The applicant sought income replacement benefits and interest on overdue medical benefits following a motor vehicle accident.

The Tribunal found that the applicant failed to prove on a balance of probabilities that he suffered a substantial inability to perform the essential tasks of his pre-accident employment, as the evidence regarding his job duties was contradictory and unclear.

Consequently, the claim for income replacement benefits was dismissed.

However, the Tribunal ordered the respondent to pay interest on the previously resolved claims for a chronic pain assessment and physiotherapy, payable once those expenses were incurred.

The applicant was injured in a motor vehicle accident and received income replacement benefits (IRBs) until the insurer terminated them, arguing his ongoing back pain was caused by post-accident weight gain rather than the accident.

The Tribunal found that the applicant's rapid weight gain and chronic pain were a result of the accident.

Relying on the applicant's medical experts, the Tribunal concluded the applicant met both the pre-104 week test of substantial inability to perform his pre-accident employment and the post-104 week test of complete inability to engage in suitable employment.

The applicant was awarded ongoing IRBs with interest, and the insurer's claim for repayment of benefits was dismissed.

The applicant sought statutory accident benefits for chiropractic treatment and a psychological assessment following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding that the applicant had reached maximum medical recovery for her physical injuries and that her ongoing complaints were due to pre-existing rheumatoid arthritis.

The Tribunal also denied the psychological assessment, relying on an insurer's examination that found no psychological injury and the applicant's own statements that she did not need psychological treatment.

Claims for an award and interest were consequently dismissed.

The applicant sought medical benefits for two physiotherapy treatment plans and the cost of an attendant care assessment following a motor vehicle accident.

The respondent insurer denied the claims on the basis that they were not reasonable and necessary, relying on independent medical examinations which concluded the applicant had reached maximum medical recovery from soft tissue injuries.

The adjudicator dismissed the application, preferring the evidence of the insurer's assessors who conducted physical examinations over the applicant's occupational therapy paper review report.

The adjudicator found the applicant had returned to full-time work, was independent in personal care, and did not require further treatment.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including a non-earner benefit, medical cannabis, and osteopathy treatments (including a treadmill and vaporizer).

The Licence Appeal Tribunal denied the non-earner benefit, finding the applicant was still able to perform many self-care and daily living activities.

However, the Tribunal granted the medical benefits for medical cannabis and osteopathy, finding them reasonable and necessary given the applicant's ongoing pain and the recommendations of his treating practitioners.

Interest on overdue payments was also awarded.