Dr. Terra Seon

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

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

The Tribunal found the applicant suffered from an accident-related psychological impairment, specifically Somatic Symptom Disorder and Adjustment Disorder, warranting removal from the MIG.

The Tribunal approved a treatment plan for a psychological assessment but denied other treatment plans for chronic pain, physiotherapy, guided exercise, and a social work assessment due to lack of supporting evidence.

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

The respondent denied several treatment and assessment plans.

The Tribunal found that the applicant was barred from proceeding to a hearing for six of the disputed plans because he failed to dispute the respondent's clear and unequivocal denials within the two-year limitation period under s. 56 of the Schedule.

The Tribunal declined to extend the limitation period under s. 7 of the LAT Act.

On the substantive issues, the Tribunal held that the applicant failed to prove that his physical or psychological injuries warranted removal from the Minor Injury Guideline (MIG).

The application was dismissed.

The applicant was injured in a motor vehicle accident and sought various medical and rehabilitation benefits, which the respondent insurer denied on the basis that 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 with functional limitations and psychological injuries, preferring the evidence of the applicant's treating professionals over the insurer's assessors.

The Tribunal ordered the respondent to pay for the disputed chiropractic services, psychological assessment, and psychological treatment, finding them reasonable and necessary.

The claims for physiatry and orthopedic assessments were dismissed as the applicant had already been diagnosed with chronic pain and failed to prove their necessity.

Interest was awarded on overdue payments.

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

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

The applicant argued for removal from the MIG based on psychological impairment, a pre-existing condition, and chronic pain.

The Tribunal found the applicant did not establish an accident-related psychological condition or chronic pain with functional impairment that would warrant removal from the MIG.

As the applicant remained subject to the MIG, the treatment plans were not considered, and the application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming his injuries—including a concussion, chronic pain, and a psychological condition—warranted removal from the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that the applicant failed to prove on a balance of probabilities that he sustained injuries falling outside the MIG.

The Tribunal preferred the respondent's expert medical evidence, which concluded the applicant suffered only minor injuries such as whiplash and a sprained shoulder.

Consequently, the applicant remained subject to the $3,500 MIG limit, and his claims for additional treatment plans, interest, and a special award were dismissed.

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

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

The applicant claimed to have sustained a psychological injury that would remove him from the MIG.

The Tribunal found that the applicant did not prove on a balance of probabilities that he suffered from a psychological injury warranting removal from the MIG, preferring the respondent's psychological assessment over the applicant's.

As the applicant remained in the MIG, the disputed treatment plans and claim for interest were dismissed.

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

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

The Tribunal found that the applicant's physical injuries, diagnosed as sprains, strains, and a partial tear, fell within the MIG definition.

Furthermore, the Tribunal accepted the respondent's psychological assessment that the applicant did not suffer a psychological injury warranting diagnosis or treatment.

As the applicant was held to the MIG and had not exhausted the $3,500 limit, the claims for additional physiotherapy, a psychological assessment, and an award were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to a psychological assessment and physiotherapy services outside the Minor Injury Guideline (MIG).

The respondent denied the benefits, arguing the applicant's injuries were minor.

The Tribunal found that the applicant failed to demonstrate psychological or physical impairments warranting removal from the MIG, preferring the respondent's insurer's examinations which were consistent with the family physician's clinical notes.

As the injuries were deemed minor and the MIG limit was exhausted, the proposed treatment plans and claim for interest were dismissed.

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

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

The applicant argued for removal from the MIG based on chronic pain and psychological impairment.

The Tribunal found the applicant did not meet the AMA Guides criteria for chronic pain and that the evidence did not support a psychological impairment.

The Tribunal concluded the applicant's injuries were predominantly minor and he remained subject to the MIG limit.

As the MIG limits were exhausted, the disputed treatment plans were not considered, and claims for interest and an award were dismissed.

The applicant sought entitlement to various treatment and assessment plans for psychological and chiropractic services following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove on a balance of probabilities that the proposed plans were reasonable and necessary.

The Tribunal preferred the evidence of the respondent's section 44 assessors, who concluded that the applicant suffered only minor physical strains and did not meet the criteria for a psychological diagnosis, over the applicant's self-reported complaints and the reports of his treating practitioners.

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

The Tribunal found the applicant failed to provide compelling evidence that her pre-existing conditions precluded recovery within the MIG, or that she suffered from chronic pain with functional impairment.

Relying on the respondent's psychological assessment, the Tribunal also concluded the applicant did not suffer from a psychological injury warranting removal.

The application for disputed treatment plans and assessments was dismissed as the applicant remained subject to the MIG limit.

The applicant sought statutory accident benefits for two chiropractic treatment plans following a motor vehicle accident.

The respondent insurer denied the benefits.

The adjudicator found that the applicant failed to prove the treatment plans were reasonable and necessary, as the medical evidence, including the insurer's independent medical examinations, indicated the applicant's ongoing pain was related to pre-existing conditions rather than the subject accident.

The application was dismissed and no interest was payable.

The applicant sought various medical, rehabilitation, and attendant care benefits following a motor vehicle accident.

The respondent denied the benefits, and the applicant applied to the Licence Appeal Tribunal.

The Tribunal found that the applicant was entitled to some of the proposed psychological, physiotherapy, and chiropractic treatment plans, primarily for the completion of OCF-18 forms and where contemporaneous medical evidence supported the need for treatment.

However, the Tribunal dismissed the claims for attendant care benefits, medication expenses, and several other treatment plans due to a lack of supporting evidence.

The request for a special award under s. 10 of Reg. 664 was also dismissed, as the applicant failed to prove the respondent acted unreasonably.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits.

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

The Tribunal found that the applicant sustained a psychological injury, removing her from the MIG, and approved treatment plans for a psychological assessment and psychological treatments.

However, the Tribunal denied the treatment plans for chiropractic treatments and a chronic pain assessment, finding insufficient medical evidence to prove they were reasonable and necessary.

The applicant was awarded interest on overdue payments but denied an award under O. Reg. 664, as the respondent's reliance on its assessors was not unreasonable.

The applicant sought entitlement to statutory accident benefits for chiropractic, massage, psychotherapy, and catastrophic determination assessments following a 2017 motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to meet her evidentiary burden to prove the treatment and assessment plans were reasonable and necessary.

The Tribunal preferred the respondent's more current section 44 assessment reports over the applicant's outdated section 25 reports and noted the lack of consistent recommendations from treating physicians.

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

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

The applicant argued for removal from the MIG due to psychological impairments, pre-existing sciatica and scoliosis, and chronic pain.

The Tribunal found insufficient medical evidence to support removal from the MIG, preferring the respondent's assessments which aligned with the family physician's clinical notes.

The application for treatment plans, interest, and a special award was dismissed.

The applicant sought non-earner benefits and a physiotherapy treatment plan following a motor vehicle accident.

The Licence Appeal Tribunal excluded several of the applicant's medical reports because they were submitted eight months past the document exchange deadline, prejudicing the respondent.

On the merits, the Tribunal dismissed the claim for non-earner benefits, finding the applicant failed to provide sufficient evidence comparing her pre- and post-accident activities to establish a complete inability to carry on a normal life.

The Tribunal preferred the respondent's multidisciplinary insurer examination reports, which found no significant functional impairments.

The claim for the physiotherapy treatment plan was also dismissed as the applicant provided minimal argument or evidence to demonstrate it was reasonable and necessary.

The applicant sought accident benefits following a motor vehicle accident but was denied by the respondent on the basis that his injuries fell within the Minor Injury Guideline (MIG).

The applicant applied to the Licence Appeal Tribunal, arguing he should be removed from the MIG due to a pre-existing back condition, chronic pain, and psychological injuries.

The Tribunal found the applicant failed to provide compelling medical evidence that his pre-existing condition precluded recovery within the MIG, or that he suffered from chronic pain with functional impairment or a psychological impairment.

The application was dismissed, and the applicant's treatment was limited to the $3,500 MIG cap.

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

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

The Tribunal found that the applicant failed to prove her injuries, including alleged psychological impairments, chronic pain, and radiculopathy, warranted removal from the MIG.

However, the Tribunal ordered the respondent to pay for certain incurred treatment expenses because the respondent failed to provide compliant denial notices under sections 38(8) and 38(9) of the Schedule.

The applicant's claim for an award for unreasonable delay was dismissed.

The applicant sought accident benefits following a motor vehicle accident, claiming his injuries warranted removal from the Minor Injury Guideline (MIG) due to chronic pain, psychological, and neurological impairments.

The Licence Appeal Tribunal found the applicant failed to meet his burden of proof, preferring the evidence of the respondent's independent medical examiners and the applicant's own family physician over the applicant's chiropractor and nurse.

The Tribunal held the applicant remained within the MIG and was therefore not entitled to an attendant care benefit.

While one of the respondent's denial letters breached s. 38(8) of the Schedule, no payment was ordered as there was no evidence the services were incurred.

Claims for treatment plans, an award, and interest were dismissed.