Dr. Sarah Talebizadeh

The applicant sought entitlement to several treatment plans for psychological, chiropractic, orthopedic, and TMJ services following a motor vehicle accident.

The Tribunal found that the applicant failed to meet her burden of proving that most of the treatment plans were reasonable and necessary, often due to a lack of corroborating medical evidence or failure to justify the costs and hourly rates claimed.

However, the Tribunal approved a $2,200 treatment plan for a chronic pain assessment, finding reasonable grounds based on contemporaneous medical records and a TMJ assessment report.

The claim for an award for unreasonable delay was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit, various treatment plans for physiotherapy and psychological services, and a chronic pain assessment.

The Tribunal found the applicant failed to prove a complete inability to carry on a normal life, noting inconsistencies between self-reported limitations and employer records.

The Tribunal also dismissed the claims for treatment plans, relying on the respondent's section 44 assessments which found no ongoing accident-related impairments warranting the disputed treatments.

Claims for interest, an award, and costs from both parties were also dismissed.

The applicant sought a non-earner benefit, interest, and an award under s. 10 of O. Reg. 664 following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to prove a complete inability to carry on a normal life.

The Tribunal preferred the respondent's multidisciplinary insurer's examination reports, which showed the applicant retained functional capacity and continued to engage in self-care and childcare, over the applicant's incomplete disability certificate.

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

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit and costs for psychological assessments and services.

The Licence Appeal Tribunal found that the applicant did not meet the test for a non-earner benefit, as he failed to demonstrate a complete inability to carry on a normal life.

However, the Tribunal granted the costs for the psychological assessment and services, finding that the additional hours billed for interpretation services and planning due to the applicant's language barrier were reasonable and necessary.

The applicant's claim for a special award under section 10 of Regulation 664 was dismissed, as the insurer's conduct was not found to be unreasonable.

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 that the applicant sustained a psychological impairment that warranted removal from the MIG, relying on corroborating evidence from multiple psychological professionals over the respondent's section 44 assessor.

Consequently, the Tribunal approved the disputed psychological assessment and treatment plans as reasonable and necessary.

However, the Tribunal dismissed the claims for physiotherapy treatment plans, finding the physical injuries were minor and the plans were not proven reasonable and necessary.

Interest was awarded on overdue benefits.

The applicant sought various statutory accident benefits following a 2019 motor vehicle accident.

The Tribunal dismissed the claims for attendant care benefits, finding the applicant failed to provide sufficient evidence that the expenses were incurred, including proof of cash payments to the service provider.

The Tribunal also denied treatment plans for social rehab counselling and hearing aids, concluding they were not reasonable and necessary.

However, the Tribunal approved the remaining balance for a psychological treatment plan, deferring to the treating psychologist's recommendation for longer sessions.

The Tribunal further ordered the respondent to pay outstanding invoices for two rehabilitation support worker plans that the respondent had previously approved in full, holding that an insurer cannot partially pay a plan it has already fully approved.

Finally, the Tribunal granted a 15% special award under s. 10 of Reg. 664, finding the respondent acted unreasonably by withholding payment for the fully approved rehabilitation support worker plans while demanding further particulars.

The applicant sought statutory accident benefits following a motor vehicle accident, including an income replacement benefit (IRB) and numerous treatment and assessment plans.

The Licence Appeal Tribunal dismissed the application in its entirety.

The adjudicator found that the applicant failed to prove a substantial inability to perform the essential tasks of his pre-accident employment, relying on the respondent's medical assessments which found no residual physical or neurological impairments preventing his return to work.

The adjudicator also denied all disputed treatment plans, finding that several were not entered into evidence, while others included unpayable expenses such as personal protective equipment (PPE) and unauthorized transportation costs.

As no benefits were payable, the claim for interest was also 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 that the applicant suffered from psychological impairments, including adjustment disorder and automobile anxiety, which warranted removal from the MIG.

The Tribunal ordered the respondent to pay $2,200.00 for a psychological assessment and interest on overdue payments, but denied the applicant's request for a special award, finding no bad faith by the respondent.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for psychological services and an accountant's report.

The insurer denied the benefits.

The Tribunal found the psychological services were reasonable and necessary to treat the applicant's adjustment disorder and specific phobia, noting the treating psychologist's recommendations and the applicant's progress.

However, the Tribunal denied the cost of the accountant's report because the applicant failed to prove he was applying for an income replacement benefit or that the report was reasonable and necessary.

The applicant was awarded the cost of the psychological services with interest.

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

The applicant disputed the denial of three treatment plans (OCF-18s) for psychological services, a pre-screen assessment, and chiropractic/massage/acupuncture services.

The Tribunal found that the respondent's denial of the psychological and pre-screen OCF-18s was non-compliant with s. 38(8) of the Schedule, entitling the applicant to the incurred amounts starting on the 11th business day after receipt.

However, the Tribunal declined to deem the expenses incurred under s. 3(8), finding the applicant contributed significantly to the delay.

The Tribunal also dismissed the claim for the chiropractic/massage/acupuncture OCF-18, finding the applicant failed to prove it was reasonable and necessary.