Dr. Saghatoleslami

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

The respondent initially placed the applicant in the Minor Injury Guideline and denied treatment plans based on section 44 assessments.

After receiving further medical documentation, the respondent voluntarily removed the applicant from the guideline and approved the disputed treatment plans.

The applicant sought a special award under section 10 of Regulation 664, arguing the 90-day delay in adjusting the file was unreasonable.

The Tribunal dismissed the claim for an award, finding the insurer's reliance on its assessors and subsequent good-faith adjustment of the file upon receiving new evidence did not constitute excessive or imprudent delay.

The applicant was awarded interest on the overdue benefits.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for physiotherapy, a concussion assessment, and a psychological assessment.

The respondent denied the benefits, initially relying on the Minor Injury Guideline (MIG).

The Tribunal found the applicant proved the physiotherapy and concussion assessment were reasonable and necessary based on clinical notes documenting pain and headaches.

The Tribunal partially approved the concussion assessment and fully approved the physiotherapy plans.

The claim for a psychological assessment balance was dismissed for lack of submissions.

The Tribunal denied the applicant's request for a special award under s. 10 of Reg. 664, finding the insurer's reliance on its medical assessors was reasonable, but awarded interest on overdue payments.

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 statutory accident benefits following a motor vehicle accident.

The Tribunal found that the applicant's injuries were predominantly minor and fell within the Minor Injury Guideline (MIG), as he failed to provide compelling medical evidence of a pre-existing condition or chronic pain that would warrant removal.

However, the Tribunal ordered the respondent to pay for two treatment plans (physiotherapy and a chronic pain assessment) because its initial denial notices failed to comply with the procedural requirements of s. 38(8) and (9) of the Schedule.

Claims for subsequent treatment plans and an award for unreasonable delay were dismissed.

The applicant sought income replacement benefits following a motor vehicle accident.

The respondent denied the benefits and raised a preliminary issue that the applicant was statute-barred from claiming pre-104 benefits due to her failure to attend section 44 insurer examinations.

The Tribunal agreed, finding the applicant failed to attend properly scheduled examinations without a reasonable explanation.

Regarding post-104 benefits, the Tribunal found the applicant did not suffer a complete inability to engage in employment, noting she had returned to work and closed her business due to pandemic lockdowns rather than accident-related impairments.

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

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

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

The Tribunal found that the applicant failed to prove on a balance of probabilities that she should be removed from the MIG due to pre-existing conditions, chronic pain, or psychological impairments.

However, the Tribunal found that the respondent's initial denial of a psychological treatment plan was non-compliant with section 38(8) of the Schedule.

As a result, the respondent was prohibited from relying on the MIG for that specific treatment plan until a compliant notice was issued.

The applicant was awarded the incurred costs for psychological services during the period of non-compliance, but her other claims for chiropractic treatment, a psychological assessment, and an award under Regulation 664 were dismissed.