Dr. Seyed Hossein Hosseini

The applicant was injured in a motor vehicle accident in February 2020 and subsequently involved in a second accident in December 2020.

He sought pre- and post-104 week income replacement benefits (IRBs) and approval for occupational therapy treatment plans.

The Tribunal found that the first accident was a necessary cause of the applicant's impairments, which were exacerbated by the second accident.

Relying on the evidence of the applicant's treating family doctor, chiropractor, and occupational therapist, the Tribunal concluded that the applicant suffered a substantial inability to perform his pre-accident tasks as a courier driver, and a complete inability to engage in any employment for which he was reasonably suited.

The Tribunal awarded the IRBs and approved the treatment plans as reasonable and necessary, but denied the applicant's request for a special award, finding the insurer's denials were based on medical opinions and not 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 suffered from a chronic pain condition with functional impairment, warranting removal from the MIG.

The Tribunal approved five physiotherapy treatment plans proposed by Active Therapy Works as reasonable and necessary, supported by the treating physician's records.

However, a treatment plan from The Rehab Centre was denied due to insufficient medical evidence.

The applicant was awarded interest on the approved overdue benefits.

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

The Tribunal found that the applicant sustained an accident-related psychological impairment, removing her from the Minor Injury Guideline.

The Tribunal awarded two psychological treatment plans and an income replacement benefit, finding that the exacerbation of her pre-accident sleep issues caused a substantial and complete inability to perform her pre-accident employment as a postal clerk.

Claims for an award for unreasonable delay were dismissed, but interest on overdue payments was granted.

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

The respondent denied several treatment plans for physiotherapy, massage, chiropractic services, and a worksite assessment.

The Tribunal found that the respondent's denial notices for the treatment plans were non-compliant with s. 38(8) of the Schedule because they lacked adequate medical reasons.

Applying the Divisional Court's decision in Suarez, the Tribunal held that the treatment plans were payable once incurred.

The Tribunal also found the worksite assessment to be reasonable and necessary based on the applicant's consistent reporting of back pain aggravated by prolonged sitting.

The applicant's claim for a bad faith award under s. 10 of O. Reg. 664 was dismissed, as the respondent's reliance on its assessors' reports was not unreasonable.

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

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

The Tribunal found that the applicant's injuries warranted removal from the MIG due to chronic pain syndrome and resulting functional limitations, relying on the family doctor's records and an independent chronic pain assessment.

However, the applicant's claims for income replacement benefits and specific treatment plans were dismissed due to a failure to produce required financial documentation and a lack of objective, contemporaneous medical evidence supporting the treatment plans.

The applicant sought medical benefits for chiropractic services and a psychological assessment following a motor vehicle accident.

The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) limit of $3,500.

The Tribunal found that the applicant's physical injuries were predominantly soft tissue in nature and that she failed to provide compelling evidence of chronic pain, psychological impairment, or pre-existing conditions that would warrant removal from the MIG.

As the proposed treatment plans exceeded the MIG limit, the application for benefits was dismissed.

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 Tribunal found the applicant failed to prove his injuries were non-minor or that he suffered from chronic pain, relying on the respondent's psychological and physiatry assessments.

As the MIG limit was exhausted, the requested treatment plans were not payable.

The Tribunal also dismissed the respondent's request for repayment of an income replacement benefit, finding the respondent failed to provide timely notice and did not establish wilful misrepresentation by the applicant.

The applicant sought statutory accident benefits following a rear-end motor vehicle accident.

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

The Tribunal found that the applicant failed to prove that pre-existing conditions, psychological impairments, or chronic pain warranted removal from the MIG.

The Tribunal preferred the insurer's psychological assessment over the applicant's, noting inconsistencies and a lack of reporting to the family doctor.

As the injuries were predominantly minor and the MIG limit was exhausted, the disputed treatment plans were not payable.