Dr. S. Dharamshi

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

The respondent denied medical benefits beyond the $3,500 limit, determining the injuries fell within the Minor Injury Guideline.

The applicant argued she suffered from chronic pain and psychological impairments exceeding the minor injury definition.

The Tribunal found the applicant failed to meet her evidentiary onus, as the medical evidence did not establish chronic pain or psychological impairments.

The application for treatment plans and an award for unreasonably withheld benefits was dismissed.

The applicant, a minor, was injured in a motor vehicle accident and sought statutory accident benefits for chiropractic treatment.

The respondent insurer denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and she had exhausted the $3,500 funding limit.

The applicant argued she should be removed from the MIG due to pre-existing knee issues, chronic pain, and psychological symptoms.

The Tribunal found insufficient evidence to support removal from the MIG, noting the applicant's return to full-time school and sports, and the lack of a chronic pain diagnosis or psychological treatment.

The application was dismissed.

The applicant was injured in a motor vehicle accident and sought medical benefits for a psychological assessment and chiropractic treatments, arguing his injuries fell outside the Minor Injury Guideline (MIG) due to chronic pain.

The Licence Appeal Tribunal found that the applicant failed to prove his injuries were outside the MIG, as there was no evidence of a pre-existing condition or that he met the criteria for chronic pain syndrome.

Relying on insurer's examinations, the Tribunal concluded the requested treatments were not reasonable and necessary.

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

The applicant was struck by a vehicle while riding her bicycle and sought statutory accident benefits for an orthopaedic assessment and physiotherapy services.

The respondent denied the claims, initially arguing the injuries fell within the Minor Injury Guideline, but later conceding they did not while maintaining the denials.

The Tribunal found that the respondent failed to provide proper medical reasons for denying the orthopaedic assessment, but ultimately dismissed the claim as the assessment was a duplication of services already provided by the applicant's treating orthopaedic surgeon.

However, the Tribunal granted the claim for physiotherapy services, finding them reasonable and necessary to provide short-term pain relief for the applicant's accident-related chronic pain syndrome.

Claims for interest and costs were dismissed.

The applicant sought statutory accident benefits following a rear-end motor vehicle collision, including attendant care, medical benefits for orthotics and chiropractic treatment, costs of examinations, and medication expenses.

The Licence Appeal Tribunal dismissed all claims, finding that the applicant failed to prove attendant care expenses were incurred and that the proposed medical treatments and assessments were neither reasonable nor necessary given the applicant's pre-existing conditions and ability to perform self-care.

The respondent's request for costs due to the applicant's disregard of page limits was also denied.

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

The insurer terminated her income replacement benefits and denied medical and rehabilitation benefits, maintaining for nearly three years that her injuries fell within the Minor Injury Guideline (MIG).

The arbitrator found that the applicant suffered a substantial inability to perform her pre-accident employment and, post-104 weeks, a complete inability to engage in suitable employment due to chronic pain.

The arbitrator granted the claimed income replacement benefits, medical benefits, and costs of examinations.

Furthermore, the arbitrator awarded a $25,000 Special Award against the insurer, finding that it had unreasonably delayed and denied benefits by relying on patently flawed medical reports and ignoring credible evidence of the applicant's chronic pain.