Dr. Sethi

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

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

After the applicant was removed from the MIG following an insurer examination, the Tribunal assessed the disputed treatment plans.

The Tribunal found that the psychological assessment, psychological services, and two medical services plans were reasonable and necessary, relying on evidence of chronic pain and adjustment disorder.

However, the Tribunal denied a transportation expense claim because the applicant failed to prove the distance exceeded 50 kilometres, and denied a chiropractic services plan because the applicant failed to submit a signed OCF-18.

Interest was awarded on the overdue payments.

The applicant sought statutory accident benefits following a motor vehicle accident, including a psychological assessment, driver's rehabilitation assessment, multidisciplinary chronic pain program, and psychological services.

The Tribunal dismissed the application, finding the applicant failed to prove the treatments were reasonable and necessary.

The psychological assessment was given no weight as it was conducted by a psychotherapist with minimal involvement from the supervising psychologist.

The driver's rehabilitation assessment was denied because the applicant's licence was suspended due to a criminal conviction.

The Tribunal preferred the evidence of the respondent's psychiatrists over the applicant's medical evidence.

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

The applicant, a pedestrian struck by a vehicle, sought statutory accident benefits for physiotherapy and a chronic pain program.

The insurer denied the treatment plans based on insurer examinations concluding the applicant had reached maximum medical improvement.

The Tribunal found the applicant's chronic pain diagnosis more consistent with the evidence and approved the treatment plans as reasonable and necessary.

The Tribunal awarded interest on overdue payments but declined to order a special award under Regulation 664, finding no evidence the insurer acted unreasonably or in bad faith.

The applicant sought statutory accident benefits for physiotherapy and a chronic pain assessment following a motor vehicle accident.

The insurer denied the treatment plans, citing a gap in treatment and an insurer's examination concluding the shoulder injury was not causally linked to the accident.

The Licence Appeal Tribunal found the treatment plans were reasonable and necessary, noting the applicant's ongoing pain and the lack of explanation from the insurer's assessor regarding causation.

The Tribunal ordered the insurer to pay for the physiotherapy and chronic pain assessment with interest, but denied the applicant's request for a bad faith award.

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

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

The Tribunal found that the insurer failed to provide notice of its denial within the required 10 business days under section 38(8) of the Schedule, and was therefore prohibited from relying on the MIG limit.

However, the Tribunal ultimately dismissed the application, finding that the applicant failed to prove on a balance of probabilities that the proposed psychological treatment was reasonable and necessary, as the objective medical evidence did not support a significant psychological impairment.