Dr. Tatiana Dumitrascu

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

The insurer held that the applicant's injuries fell within the Minor Injury Guideline (MIG) and denied several treatment plans.

The applicant argued that the denial notices contravened s. 38(8) of the Schedule, which should mandate payment.

The Tribunal found that the denial notices were sufficient and met the statutory requirements.

Furthermore, based on the medical evidence, the applicant failed to prove his injuries fell outside the MIG.

As the MIG limit was functionally exhausted, the application for the disputed treatment plans was dismissed.

The applicant sought accident benefits following a motor vehicle accident, claiming her injuries warranted removal from the Minor Injury Guideline (MIG) due to physical and psychological impairments, pre-existing conditions, and chronic pain.

The Tribunal found that the applicant's injuries were predominantly minor soft tissue injuries and that she failed to provide compelling medical evidence of a psychological impairment, pre-existing condition, or chronic pain with functional impairment that would justify removal from the MIG.

The Tribunal also dismissed the applicant's claim for a non-earner benefit, finding she had not demonstrated a complete inability to carry on a normal life.

All disputed treatment plans and claims for interest were denied.

The applicant was injured in a motor vehicle accident and sought various statutory accident benefits, including treatment plans for physiotherapy, chiropractic, psychological, and optometric services, as well as prescription expenses.

The respondent insurer denied the benefits.

The Licence Appeal Tribunal found that the applicant was entitled to the psychological services and a portion of the prescription expenses, as the medical evidence supported a diagnosis of post-traumatic stress disorder and chronic pain related to the accident.

However, the Tribunal dismissed the claims for physiotherapy, chiropractic, and optometric services, preferring the respondent's insurer examinations which found these treatments were not reasonable and necessary.

The applicant's claim for a special award under s. 10 of O. Reg. 664 was dismissed, as the respondent's reliance on its medical experts was 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 adjudicator found the applicant failed to establish chronic pain or psychological impairments warranting removal from the MIG, preferring the respondent's expert evidence.

However, the adjudicator ordered the respondent to pay for a chronic pain assessment and psychological treatment because the respondent's denial notices failed to comply with s. 38 of the Schedule by not explicitly stating that the MIG applied.

Claims for an award and costs were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming psychological impairments warranted treatment outside the Minor Injury Guideline (MIG).

The respondent denied the benefits, arguing the injuries were minor and the MIG limit was exhausted.

The Tribunal found the applicant failed to prove a psychological impairment, preferring the respondent's comprehensive psychological assessment over the applicant's expert report, which relied heavily on self-reporting.

As the applicant remained within the MIG and the $3,500 limit was exhausted, the claims for treatment plans and interest were dismissed.

The applicant was injured in a motor vehicle accident and sought various medical and rehabilitation benefits from the respondent insurer.

The insurer denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit had been exhausted.

The applicant argued she should be removed from the MIG due to pre-existing injuries and psychological impairments.

The Tribunal found insufficient evidence of pre-existing conditions preventing recovery or clinically significant psychological impairments, preferring the respondent's psychological assessment over the applicant's.

The Tribunal concluded the applicant's injuries were predominantly minor, and since the MIG limits were exhausted, the claims for treatment plans and interest were dismissed.

The applicant sought a determination that he sustained a catastrophic impairment as a result of a motor vehicle accident, along with claims for income replacement benefits, medical benefits for physiotherapy, housekeeping benefits, and cost of examinations.

The Tribunal found that the applicant's shoulder impairments were largely due to pre-existing conditions and natural degeneration, not the accident.

The Tribunal rejected the applicant's whole person impairment rating of 55%, finding that the assessors improperly included a 3% rating for medication use related to a pre-existing heart condition and an 18% rating for speculative future surgery.

The Tribunal also dismissed the claim for income replacement benefits, finding the applicant was not actively self-employed at the time of the accident due to a recent heart attack.

All claims were dismissed.

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

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

The adjudicator found that the applicant failed to prove that his pre-existing conditions prevented maximal recovery within the MIG.

Furthermore, the adjudicator preferred the respondent's psychological assessments, which included validity testing, over the applicant's evidence, concluding that the applicant did not suffer from a psychological impairment or chronic pain that would remove him from the MIG.

The application was dismissed.

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

The respondent denied the claims on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG), capping benefits at $3,500.

The applicant argued that he sustained psychological injuries that removed him from the MIG.

The Tribunal preferred the respondent's psychological assessment, which included validity testing indicating symptom magnification, over the applicant's evidence.

The Tribunal found the applicant's injuries were predominantly minor and subject to the MIG cap.

A preliminary motion by the respondent to strike the applicant's Reply submissions for case splitting was dismissed.

The applicant sought a medical benefit for psychological services following a motor vehicle accident.

The insurer denied the treatment plan based on an insurer examination.

The Tribunal found the applicant's self-reporting to his own psychologist was contradicted by his statements to the insurer's assessor, where he minimized his symptoms.

Given the lack of corroborating evidence and the unexplained discrepancies in self-reporting, the Tribunal concluded the applicant failed to prove the treatment plan was reasonable and necessary.

The claims for the medical benefit, a special award, and interest were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including income replacement benefits, medical benefits, transportation expenses, an assessment expense, interest, and a special award.

The arbitrator found that credible psychological and orthopedic evidence established chronic pain and related psychological sequelae, taking the claim outside the Minor Injury Guideline and supporting entitlement to the disputed physiotherapy treatment plans.

Applying the Schedule's pre-104-week test, the arbitrator held that the applicant had a substantial inability to perform the essential tasks of his pre-accident employment and was entitled to weekly income replacement benefits for that period only.

The post-104-week claim failed because the evidence did not prove a complete inability to engage in any suitable employment.

Transportation and interest were awarded, the in-home assessment expense and special award were denied, and expenses were left to further determination if necessary.