Shoabana Kugathasan

The applicant sought medical and rehabilitation benefits following a motor vehicle accident, including osteopathic, chiropractic, and occupational therapy services.

The Tribunal found the applicant was entitled to osteopathic services at a rate of $80.00 per hour, as osteopaths are not relegated to the lowest rate under the Professional Services Guideline.

However, the claims for chiropractic services and an occupational therapy assessment were dismissed, as the insurer's section 44 assessments demonstrated the applicant had reached maximum medical improvement and did not suffer from functional impairments warranting further treatment.

The claim for a section 10 award was dismissed, but interest was awarded on the overdue osteopathic benefits.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including attendant care benefits and various treatment plans.

The respondent denied the claims.

The Tribunal found that the applicant failed to prove the attendant care benefits were incurred or reasonable and necessary, preferring the respondent's section 44 assessments.

The Tribunal also dismissed the claims for the outstanding balances of several partially approved treatment plans, finding the applicant did not meet her burden to establish their reasonableness and necessity.

The application was dismissed in its entirety.

The applicant sought accident benefits following a motor vehicle accident, including income replacement benefits (IRBs) and occupational therapy services.

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

The Licence Appeal Tribunal found that the applicant's soft tissue injuries were predominantly minor and subject to the MIG limit, which had been exhausted.

The Tribunal also dismissed the claim for IRBs, finding the applicant failed to prove a substantial inability to perform the essential tasks of her pre-accident employment as a general labourer.

The application was dismissed in its entirety.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming his injuries fell outside the Minor Injury Guideline (MIG) due to pre-existing conditions, psychological impairments, and chronic pain.

The Licence Appeal Tribunal found the applicant failed to provide compelling medical evidence of pre-existing conditions or psychological injuries that would prevent maximal recovery within the MIG limits.

The Tribunal preferred the insurer's medical examinations, which concluded the injuries were minor soft tissue strains.

As the applicant's injuries were deemed minor and the $3,500 MIG limit was exhausted, the claims for additional physiotherapy and orthopaedic assessments were dismissed.

The applicant sought various statutory accident benefits following a 2017 motor vehicle accident, including attendant care benefits, occupational therapy, assistive devices, and assessments.

The Licence Appeal Tribunal found that the applicant's ongoing impairments were caused by pre-existing degenerative conditions rather than the accident, relying on the respondent's orthopaedic assessment.

The Tribunal denied further attendant care benefits and most treatment plans, but approved a psychological assessment, an attendant care assessment, and an inner bathmat.

The claim for a special award was dismissed as the respondent did not act unreasonably or in bad faith.

The applicant sought statutory accident benefits following a motor vehicle accident, including non-earner benefits, attendant care benefits, and various treatment plans.

The Tribunal found that the insurer failed to properly deny the non-earner benefits and a psychological assessment treatment plan in accordance with the Statutory Accident Benefits Schedule, entitling the applicant to those benefits for the period of the insurer's non-compliance.

However, the applicant failed to prove a complete inability to carry on a normal life for the ongoing period.

The Tribunal also awarded a 25% penalty under O. Reg. 664 due to the insurer's unreasonable delay in adjusting the claim, particularly given the applicant's known vulnerability due to pre-existing schizophrenia.