Dr. Todd Walters

The applicant sought statutory accident benefits for medical cannabis and chiropractic treatment following a 2017 motor vehicle accident.

The respondent denied the benefits, relying on insurer examination reports indicating the applicant had reached maximal medical improvement and did not suffer from chronic pain or a sleep disorder as a result of the accident.

The adjudicator dismissed the application, finding the applicant failed to provide objective medical evidence to prove the treatment plans were reasonable and necessary.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming her physical and psychological injuries, as well as chronic pain, warranted removal from the Minor Injury Guideline (MIG).

The respondent denied the claims, arguing the injuries were soft tissue in nature and resolved prior to a subsequent workplace accident.

The Tribunal found that the applicant failed to prove causation, as medical evidence indicated her motor vehicle accident injuries had resolved before the workplace incident.

The Tribunal also rejected the applicant's psychological and chronic pain claims, preferring the corroborating medical evidence that showed no such impairments prior to the workplace accident.

The application was dismissed, and the applicant was not entitled to the disputed treatment plans, an award, or interest.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to psychological treatment, a driver's reintegration evaluation, and physiotherapy.

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

The Tribunal found that the applicant failed to prove the treatment plans were reasonable and necessary, relying on the opinions of the insurer's examiners who found no ongoing musculoskeletal or neurological impairment and that the psychological treatment proposed was excessive or premature.

The application was dismissed.

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 chronic pain syndrome, psychological impairments, and a pre-existing lipoma.

The Tribunal found insufficient objective medical evidence to support chronic pain with functional impairment or a psychological impairment, noting that the applicant's expert relied heavily on self-reporting.

The Tribunal concluded the applicant's injuries were predominantly minor and subject to the MIG limit, which had already been exhausted.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including chiropractic treatment, a psychological assessment, a chronic pain assessment, a special award, and interest.

The adjudicator found no jurisdiction over the chiropractic treatment plans as they had already been approved by the respondent and the dispute arose from improper invoicing.

The claim for the remaining cost of a psychological assessment was dismissed because the applicant failed to prove that fees exceeding the guideline rate were reasonable.

However, the adjudicator granted the cost of a chronic pain assessment, finding it necessary to explore the applicant's pain complaints and rejecting the respondent's medical examination report.

The claim for a special award for unreasonable delay was dismissed, but interest was awarded on the approved chronic pain assessment.

The applicant sought an income replacement benefit (IRB) following a motor vehicle accident, claiming she suffered a substantial inability to perform her pre-accident employment duties as a lab technician assistant.

The respondent insurer terminated the IRB based on insurer examinations concluding the applicant sustained only minor strain injuries and did not suffer a substantial inability to work.

The tribunal dismissed the application, finding the applicant failed to present expert medical evidence or other proof demonstrating a substantial inability to perform her essential work tasks, while the medical evidence suggested she should remain active and attempt to return to work.

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

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

The applicant argued they suffered from chronic pain syndrome and psychological impairments that removed them from the MIG.

The Tribunal found that the applicant's injuries were predominantly minor, noting that the applicant returned to regular work duties shortly after the accident and did not demonstrate functional impairment.

The Tribunal preferred the evidence of the insurer's examination assessors over the applicant's pain specialist, who relied heavily on self-reporting during a virtual assessment.

The application was dismissed.

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

The respondent denied a treatment plan for physiotherapy 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 he should be removed from the MIG due to pre-existing conditions and chronic pain.

The Tribunal found that while the applicant had pre-existing conditions, they had largely resolved prior to the accident and did not prevent maximal recovery within the MIG.

The Tribunal also found insufficient evidence of chronic pain.

As the MIG limits were exhausted, the claim for further physiotherapy, along with claims for an award and interest, were dismissed.

The applicant sought payment for a psychological assessment and a chronic pain assessment following a motor vehicle accident.

The Tribunal denied the psychological assessment because the applicant incurred the cost before the treatment plan was properly submitted to the respondent, violating s. 38(2) of the Schedule.

However, the Tribunal granted the chronic pain assessment, finding it reasonable and necessary given the applicant's exacerbation of pre-existing pain and functional limitations.

The claim for an award under s. 10 of O. Reg. 664 was dismissed as the insurer's denials were not unreasonable.

The applicant sought accident benefits following a motor vehicle accident, disputing the insurer's determination that his injuries fell within the Minor Injury Guideline (MIG) and the termination of his income replacement benefits (IRBs).

The Tribunal found that the applicant's physical injuries, including left shoulder bursitis, were minor and not caused by the accident.

The Tribunal rejected the applicant's claim of chronic pain syndrome, giving little weight to his medical expert's report due to a lack of analysis and missing medical history.

The Tribunal also drew an adverse inference from the applicant's failure to produce relevant employment and medical records.

Consequently, the Tribunal held that the applicant's injuries were subject to the MIG limit, which had been exhausted, and that he failed to prove entitlement to IRBs.

The applicant sought a medical and rehabilitation benefit of $2,661.57 for physiotherapy following a motor vehicle accident, along with interest and an award for unreasonable delay.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to provide any medical evidence or argument to prove the treatment was reasonable and necessary.

The insurer's examination concluded the treatment was not required, and the applicant's criticisms of the insurer's claims adjustment process did not substitute for positive medical evidence.

Consequently, the claims for interest and an award were also dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including costs for a physiatry assessment, an occupational therapy assessment, acupuncture, and pharmacotherapy.

The respondent denied the claims based on insurer's examinations concluding the applicant suffered only from minor physical injuries.

The Tribunal found the applicant's medical evidence, which diagnosed concussion, post-concussive disorder, and chronic pain, outweighed the respondent's evidence.

The Tribunal ordered the respondent to pay the disputed benefits and interest.

However, the Tribunal dismissed the applicant's claim for a special award, finding the respondent had reasonable grounds to doubt the claims based on its own specialist reports.

The applicant sought statutory accident benefits following a motor vehicle accident, including medical benefits, housekeeping expenses, and a special award.

Despite the applicant's failure to attend the hearing, his counsel proceeded.

The arbitrator dismissed the claims for medical benefits, preferring the evidence of the insurer's medical experts who conducted physical examinations over the applicant's expert who only performed a paper review.

The arbitrator also found that the treatment facility had overbilled for the duration of sessions.

The claims for housekeeping and a special award were dismissed due to lack of evidence and the finding that no benefits were unreasonably withheld.

The insurer was awarded its arbitration expenses.

The applicant was injured in a motor vehicle accident and received income replacement benefits for approximately six months before the insurer terminated them.

The applicant sought arbitration, claiming ongoing disability due to back and leg pain.

As a preliminary issue, the applicant argued the termination notice was defective under section 37 of the Statutory Accident Benefits Schedule.

The arbitrator found the insurer provided proper notice or, alternatively, substantially complied.

On the merits, the arbitrator found the applicant lacked credibility, noting significant inconsistencies in his testimony regarding his pre-accident employment, a prior back injury sustained in India, and his physical limitations.

Medical evidence and surveillance video showing the applicant performing heavy lifting contradicted his claims of severe pain and a pronounced limp.

The arbitrator concluded the applicant exaggerated his symptoms and did not suffer a substantial inability to perform the essential tasks of his employment.

The application was dismissed, and the applicant was ordered to pay the insurer's expenses.