Dr. Seyed Hosseini

The applicant sought income replacement benefits (IRBs) post-104 weeks, as well as payment for chiropractic services and catastrophic assessments following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to prove a complete inability to engage in suitable employment, relying on surveillance evidence and independent medical examinations showing the applicant could perform employment-type activities.

The Tribunal also found the proposed treatment plans and assessments were not reasonable and necessary, as they were duplicative of previously completed programs or lacked justification.

Claims for interest and an award were consequently dismissed.

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

The respondent denied several treatment plans, and the applicant applied to the Licence Appeal Tribunal.

The Tribunal found that the applicant was statute-barred from disputing four treatment plans because she failed to apply within the two-year limitation period under s. 56 of the Schedule, and declined to extend the time under s. 7 of the LAT Act.

On the substantive issues, the Tribunal held that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant failed to prove that a pre-existing condition, chronic pain, or psychological impairment warranted removal from the MIG.

Consequently, the remaining treatment plan for chiropractic services was denied, and no interest was payable.

The application was dismissed.

The applicant sought entitlement to statutory accident benefits for chiropractic services and a psychological assessment following a 2018 motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding that the proposed treatment plans were not reasonable and necessary.

The Tribunal accepted the uncontested medical opinion of the respondent's physiatrist that the applicant had reached maximum medical improvement regarding physical therapy.

Furthermore, the Tribunal found the proposed psychological assessment to be duplicative, as the applicant had already received a funded psychological assessment in 2019 but failed to attend the approved counselling sessions or raise psychological concerns with his family physician.

Claims for an award and interest were also dismissed.

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) and that disputes for two plans were statute-barred.

The Tribunal found the applicant was barred from disputing the orthopaedic and physiotherapy plans because she failed to apply within the two-year limitation period under s. 56 of the Schedule, and declined to extend the time under s. 7 of the LAT Act.

Furthermore, the Tribunal held the applicant failed to establish that she suffered from accident-related chronic pain or psychological impairments warranting removal from the MIG.

As the MIG limits were exhausted, the claim for psychological services was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to treatment plans for physiotherapy, chiropractic services, and psychological and chronic pain assessments outside the Minor Injury Guideline (MIG).

The Tribunal found the applicant failed to prove his injuries warranted removal from the MIG, noting his functional abilities and return to work were inconsistent with chronic pain or psychological impairment.

As the MIG limits were exhausted, the treatment plans were not payable.

The Tribunal also found the respondent's denial notices complied with s. 38(8) of the Schedule and dismissed claims for interest and a punitive award.

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

The insurer denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued that pre-existing neck and back pain from previous accidents warranted removal from the MIG.

The Tribunal found that the medical evidence did not establish a documented pre-existing condition that would prevent maximal recovery within the MIG.

The application for treatment plans and interest was dismissed.

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

The respondent denied treatment plans for a psychological assessment, chronic pain assessment, and physiotherapy, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found the applicant's injuries were predominantly minor, relying on the respondent's s. 44 assessors and noting a lack of compelling medical evidence of chronic pain or psychological impairment.

Although the respondent breached the 10-day response requirement under s. 38(8) for the physiotherapy treatment plan, no amounts were payable as the treatment was not incurred during the delay.

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

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

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

The applicant argued that she suffered from chronic pain and psychological impairments that removed her from the MIG.

The Tribunal found that the applicant failed to demonstrate on a balance of probabilities that her functionality was impaired by chronic pain or that she sustained a psychological injury outside the minor injury definition.

As the injuries were deemed minor, the disputed treatment plans exceeding the $3,500 MIG limit were not payable.

The application was dismissed.

The applicant sought statutory accident benefits for medical and rehabilitation treatments following a motor vehicle accident.

The insurer denied the 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 applicant argued that psychological impairments and a pre-existing condition of Crohn's disease removed him from the MIG.

The Tribunal found that the applicant suffered only soft tissue injuries, failed to establish a psychological impairment, and did not provide compelling evidence that his Crohn's disease prevented maximal recovery under the MIG.

The application was dismissed.

The applicant was injured in a motor vehicle accident and sought income replacement benefits (IRBs) beyond the date the insurer terminated them.

The adjudicator found that the applicant suffered a substantial inability to perform the essential tasks of his pre-accident employment as a gas station owner/operator, as his accident-related impairments prevented him from working the required hours.

The applicant was awarded IRBs for the disputed period, subject to a deduction of 70% of his post-accident employment income.

The insurer was entitled to a repayment of overpaid IRBs based on this deduction, and the applicant was awarded interest on overdue payments.