Dr. Ricardo Harris

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 for removal from the MIG based on a pre-existing shoulder condition, chronic pain, and psychological impairments.

The Tribunal found insufficient compelling medical evidence to support removal on any of these grounds, preferring the respondent's section 44 assessments which concluded the injuries were minor.

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

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

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

The Tribunal found the applicant suffered from chronic pain with functional impairment, warranting removal from the MIG.

The Tribunal granted the applicant's requests for chronic pain and psychological assessments, as well as chiropractic and massage treatment, finding them reasonable and necessary.

A psychological treatment plan was partially approved, while a duplicative psychotherapy plan was denied.

The Tribunal declined to order a special award under s. 10 of Regulation 664, finding the respondent reasonably relied on its assessors' opinions, but awarded interest on overdue benefits.

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

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

The Tribunal found the applicant sustained a psychological impairment as a result of the accident, warranting removal from the MIG.

The Tribunal preferred the evidence of the applicant's treating practitioners and section 25 assessor over the respondent's section 44 examiners.

The Tribunal ordered the respondent to pay for the disputed physiotherapy treatment plans, an orthopaedic assessment, a psychological assessment, and psychological services, finding them reasonable and necessary.

Interest was also awarded on overdue benefits.

The applicant sought statutory accident benefits following a motor vehicle accident, arguing his injuries fell outside the Minor Injury Guideline (MIG) due to pre-existing conditions (spinal fusion, Brown-Sequard Syndrome), chronic pain, and psychological impairments.

The Tribunal found the applicant failed to prove his pre-existing conditions precluded maximal medical recovery within the MIG.

Claims of chronic pain and psychological injury were unsupported by persuasive medical evidence, with the Tribunal noting inconsistencies in the applicant's reported vehicular phobia.

The Tribunal also dismissed the claim for a non-earner benefit, finding the applicant did not suffer a complete inability to carry on a normal life.

All disputed treatment plans, interest, and an award under s. 10 of Regulation 664 were denied.

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 suffered from accident-related psychological impairments, including PTSD and depression, which removed him from the MIG.

Because the insurer's denials were based solely on the MIG, and an insurer cannot split the determination once an insured is removed from the MIG, the Tribunal ordered payment of the disputed physiotherapy and psychological treatment plans.

A claim for prescription expenses was denied for lack of evidence.

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, who was 10 years old at the time of the motor vehicle accident, sought removal from the Minor Injury Guideline (MIG) and entitlement to various psychological treatment plans.

The Tribunal found that the applicant sustained accident-related psychological injuries, including PTSD and vehicular anxiety, warranting removal from the MIG.

The Tribunal approved treatment plans for psychological services and a psychological assessment, finding them reasonable and necessary.

However, a proposed family psychological assessment was denied as duplicative.

The applicant's claim for a special award under s. 10 of Reg. 664 was dismissed, but interest on overdue benefits was granted.

The applicant requested a reconsideration of a Tribunal decision that denied his entitlement to a post-104 week Income Replacement Benefit (IRB) and found that the quantum for his pre-104 week IRB could not be determined.

The Vice-Chair dismissed the request to admit new tax documents to determine the IRB quantum, finding the applicant failed to show the evidence could not have been obtained previously.

However, the Vice-Chair found the original adjudicator committed an error of law by failing to explicitly engage with the expert evidence regarding the post-104 week IRB test.

Upon reviewing the evidence, the Vice-Chair concluded the applicant suffers from a complete inability to engage in reasonably suited employment due to chronic pain and cognitive struggles.

The decision was varied to find entitlement to the post-104 week IRB, though no benefit is currently payable as the quantum remains undetermined.

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

The applicant argued for removal from the MIG based on pre-existing conditions, chronic pain, and psychological impairments.

The Tribunal found that the applicant failed to provide compelling medical evidence that her pre-existing conditions prevented maximal medical recovery, or that she suffered from chronic pain with functional impairment or a psychological condition warranting removal.

The application for disputed treatment plans and interest was dismissed.

The applicant was involved in a single-vehicle collision with a guardrail.

His vehicle was towed to a Collision Reporting Centre, where he slipped and fell on a snow-covered hill, fracturing his ankle.

He sought statutory accident benefits, claiming his injuries were caused by the collision.

The Tribunal found that the applicant was not involved in an 'accident' as defined by s. 3(1) of the Schedule, as the slip and fall was an intervening act that directly caused his injuries, breaking the causal link to the use or operation of the automobile.

The application for benefits was dismissed.

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

The respondent denied benefits beyond the $3,500 Minor Injury Guideline (MIG) limit.

The applicant argued that her physical injuries, pre-existing alopecia, psychological impairments, and chronic pain warranted removal from the MIG.

The Tribunal found that the applicant's physical injuries were uncomplicated soft-tissue injuries.

The Tribunal preferred the respondent's medical evidence, noting that the applicant's psychological and chronic pain diagnoses were not supported by her family physician's clinical notes and records, and that her experts failed to review fulsome medical documentation.

The application was dismissed, and the disputed treatment plans were found not payable.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits for psychological services, a chronic pain management program, and physical therapy.

The respondent partially denied the psychological services and fully denied the other treatment plans.

The Tribunal found that the psychological services, to be provided by a registered psychotherapist, were reasonable and necessary, and that the respondent unreasonably withheld payment by applying the unregulated professional rate.

The Tribunal awarded the disputed amount for psychological services, plus a 25% award under s. 10 of Reg. 664 and interest.

The claims for the chronic pain management program and physical therapy were dismissed, as the Tribunal preferred the respondent's medical evidence that the applicant had reached maximum medical recovery and did not meet the criteria for chronic pain.

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

The adjudicator found the applicant was entitled to the disputed amount for a psychological services treatment plan, noting that psychotherapy is a regulated profession and the respondent failed to provide sufficient explanations for its partial denial.

The adjudicator dismissed the claims for a chronic pain management program and a physical therapy treatment plan, preferring the respondent's medical experts who opined the applicant had reached maximum medical recovery.

An award of 25% under s. 10 of Reg. 664 was granted for the respondent's unreasonable handling of the psychological services claim, along with interest.

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

The insurer denied treatment plans and non-earner benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant failed to prove she sustained a psychological impairment warranting removal from the MIG.

However, the Tribunal held that the insurer's denial notices failed to provide sufficient medical reasons as required by sections 38(8) and 36(4) of the Schedule.

Consequently, the insurer was prohibited from relying on the MIG for the disputed treatment plans, and the treatment plans and non-earner benefits were payable due to the insurer's procedural non-compliance.

The applicant, a cyclist who was struck by a car door, sought statutory accident benefits for psychological services to address her fear of cycling.

The insurer denied the treatment plan, arguing it was not reasonable and necessary and had not been incurred.

The Licence Appeal Tribunal found the applicant's self-reporting compelling and preferred the evidence of her psychologist over the insurer's expert.

The Tribunal held that the treatment plan was reasonable, necessary, and incurred, ordering the insurer to pay the benefit of $1,196.88 plus interest.

The applicant sought a non-earner benefit and the cost of an in-home assessment following a motor vehicle accident.

The adjudicator found the applicant was not a reliable witness and had failed to disclose significant post-accident activities, such as travelling, working, and doing housework, to her medical assessors.

Consequently, the adjudicator placed little weight on the applicant's medical reports and concluded she did not meet the stringent test for a non-earner benefit.

However, the adjudicator ordered the respondent to pay for the incurred in-home assessment and applicable interest.

The applicant's request for costs was denied.

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

The insurer denied certain benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG), which caps medical and rehabilitation benefits at $3,500.

The applicant brought a preliminary issue hearing challenging the constitutionality of the MIG under the Charter.

The arbitrator found that the MIG's inclusion of 'clinically associated sequelae' and its requirement that pre-existing conditions be documented before the accident discriminated against individuals with chronic pain and undocumented pre-existing conditions, violating section 15(1) of the Charter.

The infringement was not justified under section 1.

The arbitrator read down the definition of 'clinically associated sequelae' to exclude chronic pain and severed the requirement for pre-accident documentation.

The applicant was injured in a motor vehicle accident and received an Income Replacement Benefit (IRB) until the respondent insurer terminated it, claiming the applicant could return to work.

The applicant sought reinstatement of the IRB, arguing he was physically and psychologically incapable of working.

The Tribunal found that while the applicant's physical injuries had healed, the accident materially worsened his pre-existing depression and caused severe post-traumatic stress disorder.

Preferring the evidence of the applicant's treating psychologists over the insurer's assessor, the Tribunal concluded the applicant suffered a complete inability to engage in any suitable employment.

The Tribunal ordered the respondent to pay the outstanding IRB amounts with interest.