Dr. Urovitz

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

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

As a preliminary issue, the Tribunal extended the two-year limitation period for two disputed plans under s. 7 of the LAT Act, finding a bona fide intention to appeal, minimal delay due to surgery, and no prejudice to the respondent.

On the merits, the Tribunal found the requested physiotherapy, chronic pain assessment, and assistive devices to be reasonable and necessary, preferring the objective corroborating medical evidence of the applicant's treating practitioners over the respondent's paper review and independent medical examinations.

The claim for an attendant care assessment was dismissed for lack of evidence.

Interest was awarded on overdue benefits.

The applicant requested a reconsideration of a previous Licence Appeal Tribunal decision that denied various treatment plans, interest, and an award.

The applicant argued the Tribunal acted outside its jurisdiction by removing undisputed issues and made errors of law or fact in its analysis of the evidence.

The Tribunal dismissed the request, finding that the applicant failed to meet the high threshold for reconsideration and was attempting to re-litigate the original decision.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming entitlement to an in-home assessment and five chiropractic treatment plans.

The respondent had removed the applicant from the Minor Injury Guideline (MIG) prior to the hearing.

The Tribunal found that the applicant failed to prove on a balance of probabilities that the disputed treatment plans were reasonable and necessary, noting that the medical evidence did not adequately explain why five duplicative chiropractic plans were required.

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

The applicant sought entitlement to statutory accident benefits following a motor vehicle accident, including multiple treatment plans for physiotherapy, chiropractic, and psychological services, as well as attendant care benefits.

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

The Tribunal preferred the evidence of the respondent's independent examiners over the applicant's assessors and noted the applicant's failure to provide requested information to the insurer.

Claims for interest and an award under s. 10 of Reg. 664 were also dismissed.

The applicant sought statutory accident benefits following a 2017 motor vehicle accident, claiming catastrophic impairment and entitlement to income replacement benefits, treatment plans, and a special award.

The respondent denied the benefits, arguing the applicant's impairments were caused by a prior 2015 accident, pre-existing conditions, and subsequent unrelated incidents.

The Tribunal found that the applicant failed to prove on a balance of probabilities that her injuries were caused by the 2017 accident, noting her failure to follow medical advice regarding the prolonged use of a knee brace.

Consequently, the Tribunal dismissed the claims for catastrophic impairment, income replacement benefits, treatment plans, and the special award.

This medical malpractice action concerned the plaintiff's claim of chronic pain resulting from the defendants' alleged negligence in treating a ruptured Achilles tendon.

The court found that while Dr. Boivin breached the standard of care by failing to properly immobilize the plaintiff's foot or refer her to a specialist, and Kingsway Health Centre was negligent in administrative follow-up, these breaches did not cause the plaintiff's injuries.

The plaintiff's own non-compliance with medical advice and delay in seeking surgery were found to be the cause of her worsened condition.

The court also found the plaintiff to be an unreliable and incredible witness regarding her injuries and financial losses.

The action was dismissed.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including a non-earner benefit, treatment plans for physiotherapy and assistive devices, interest, and a special award.

The Licence Appeal Tribunal found that the applicant was not entitled to the non-earner benefit because he did not suffer a complete inability to carry on a normal life, noting he returned to school and engaged in more activities post-accident than pre-accident.

However, the Tribunal approved the three treatment plans for physiotherapy and the balance of the plan for assistive devices, finding them reasonable and necessary to treat his ongoing left elbow impairment.

Interest was awarded on the approved plans.

The claim for a special award was dismissed as the insurer's reliance on its medical assessors was not unreasonable.

The applicant sought an award under s. 10 of Regulation 664, arguing the respondent insurer unreasonably withheld and delayed income replacement benefits (IRBs) following a motor vehicle accident.

The Tribunal found the respondent acted unreasonably by relying solely on an insurer examination report that contradicted other medical evidence, and by failing to reassess the claim when new medical information, including surgical records, was provided.

The Tribunal awarded the applicant a lump sum of 35% of the withheld IRBs plus interest.

The applicant's request for costs was denied.

The applicant sought medical benefits for psychological and chiropractic services following a motor vehicle accident.

The respondent insurer denied the treatment plans.

The Licence Appeal Tribunal found that the applicant failed to prove the treatment plans were reasonable and necessary.

The psychological treatment plan lacked necessary details about the providers, and the applicant failed to provide requested information.

The chiropractic treatment plan was not supported by medical evidence, and the Tribunal preferred the evidence of the respondent's orthopaedic surgeon who found no objective signs of impairment.

The application was dismissed.

The applicant sought various medical benefits, transportation expenses, and assessment costs under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The respondent denied the claims.

The Tribunal found the applicant's evidence lacked credibility due to inconsistent self-reports regarding the accident details and his functional limitations.

Relying on the respondent's independent medical examinations, which found the applicant had recovered and returned to his normal activities, the Tribunal concluded the applicant failed to prove the disputed treatment plans and assessments were reasonable and necessary.

The application was dismissed.

The applicant was injured in a motor vehicle accident and sought medical, rehabilitation, and non-earner benefits from the respondent insurer.

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

The applicant contended that psychological impairments and chronic pain removed him from the MIG.

The Tribunal found that the applicant failed to prove on a balance of probabilities that he suffered from psychological impairments or chronic pain caused by the accident.

The Tribunal concluded the injuries were predominantly minor and treatable within the MIG.

Furthermore, the applicant was not entitled to a non-earner benefit as he did not suffer a complete inability to carry on a normal life, nor was the proposed chiropractic treatment reasonable and necessary.

The applicant sought statutory accident benefits, including a non-earner benefit and medical benefits, following a motor vehicle accident.

The respondent denied the benefits on the basis that the applicant's impairments were caused by pre-existing spinal degeneration rather than the accident.

The Tribunal found that the applicant failed to establish on a balance of probabilities that the accident caused her current impairments, noting that her medical records showed extensive pre-existing spinal issues and that her post-accident complaints were inconsistent with her self-reports to expert assessors.

The appeal was dismissed.

The applicant was injured in a motor vehicle accident and sought ongoing Income Replacement Benefits (IRBs), medical and rehabilitation benefits outside the Minor Injury Guideline (MIG), and a Special Award.

The arbitrator found that the applicant suffered a substantial inability to perform his pre-accident employment for the first 104 weeks, entitling him to IRBs for that period.

However, the applicant failed to prove a complete inability to engage in any suitable employment beyond the two-year mark.

The arbitrator also concluded that the applicant's injuries, including alleged chronic pain and psychological impairments, did not remove him from the MIG, as the insurer's medical evidence demonstrating no objective impairment was preferred.

The claims for additional treatment plans and a Special Award were dismissed.

The applicant was struck by a car while walking on a sidewalk, sustaining a head injury that resulted in chronic severe headaches.

The insurer paid weekly income benefits and medical benefits until November 1994, when it terminated benefits on the basis that the applicant was physically capable of returning to work.

The applicant applied for arbitration, seeking ongoing weekly income benefits and payment for chiropractic treatments.

The arbitrator found the applicant's subjective complaints of severe headaches to be credible and concluded that he was continuously prevented from engaging in any occupation for which he was reasonably suited, entitling him to ongoing weekly income benefits.

The arbitrator remained seized of the issue regarding the reasonableness of the chiropractic expenses due to insufficient evidence.

A post-hearing request by the insurer to reopen the proceedings to admit fresh evidence was dismissed, as the evidence could have been produced with due diligence and would not have changed the outcome.

The applicant was injured in a motorcycle accident and received weekly income benefits for over four years.

The insurer terminated benefits under the post-156 week test.

The applicant, a young unskilled labourer who underwent a hip replacement, argued he was continuously prevented from engaging in suitable employment.

The arbitrator found that while the applicant could no longer perform heavy physical labour, he was capable of performing sedentary work such as light assembly or delivery driving.

The arbitrator concluded the applicant was reasonably suited for these jobs by education, training, and experience, and dismissed the claim for ongoing weekly income benefits.