Dr. Yuri Marchuk

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

The respondent insurer denied benefits beyond the Minor Injury Guideline (MIG) limit and alleged the applicant was barred from receiving Income Replacement Benefits (IRB) due to a material misrepresentation regarding the use of his vehicle for ride-sharing.

The Tribunal found the respondent failed to prove the vehicle was used for ride-sharing, so the applicant was not barred from IRB and the respondent was not entitled to repayment of previously paid IRB.

However, the Tribunal concluded the applicant's injuries were predominantly minor, preferring the respondent's medical experts over the applicant's expert due to a lack of objective evidence.

As the MIG limit was exhausted, the applicant was not entitled to the disputed medical and attendant care benefits.

The applicant sought attendant care benefits and several treatment plans for psychological, chiropractic, and occupational therapy services following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove the benefits were reasonable and necessary.

The Tribunal preferred the respondent's insurer's examination reports over the applicant's medical evidence, noting significant contradictions between the applicant's own examination under oath testimony—where she reported being largely independent and emotionally well—and the severe impairments documented by her assessors.

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

The Tribunal found that the applicant's injuries were predominantly minor and subject to the Minor Injury Guideline (MIG).

However, the applicant was awarded a physiotherapy treatment plan because the respondent insurer failed to provide a proper denial notice under s. 38(8) of the Schedule.

The Tribunal dismissed the claim for a psychological assessment and a special award.

Furthermore, the Tribunal ordered the applicant to repay $16,931.56 in income replacement benefits, finding that the applicant wilfully misrepresented his employment status by returning to work as a realtor and operating a short-term rental business without disclosing the income to the insurer.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming entitlement to a chronic pain assessment and a chronic pain management program.

The Tribunal found the chronic pain assessment was not reasonable and necessary as it duplicated a previous assessment.

However, the Tribunal found the chronic pain management program was reasonable and necessary, awarding a portion of the outstanding balance, as the evidence showed the accident exacerbated the applicant's pre-existing chronic pain.

The claim for a special award under s. 10 of Regulation 664 was dismissed.

The applicant sought statutory accident benefits for physiotherapy and assistive devices following a 2017 motor vehicle accident.

The insurer denied the treatment plans based on an insurer's examination which concluded the applicant had reached maximum medical improvement.

The Licence Appeal Tribunal found the applicant failed to prove the treatment plans were reasonable and necessary, noting a lack of contemporaneous medical evidence supporting the need for ongoing facility-based treatment four years post-accident.

The application was dismissed, and claims for interest and a special award were denied.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the respondent's determination that his injuries fell within the Minor Injury Guideline (MIG).

The applicant failed to provide written submissions or comply with Tribunal deadlines.

Relying on the respondent's multidisciplinary assessments, the Tribunal found the applicant's injuries were predominantly minor and did not warrant removal from the MIG.

The application for treatment plans and interest was dismissed.

Due to the applicant's unreasonable behaviour and bad faith in the proceeding, the Tribunal ordered costs of $1,000 against the applicant.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits, including income replacement benefits (IRB) and various treatment plans.

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, including a claimed pars defect, and psychological impairments did not warrant removal from the MIG.

The Tribunal preferred the respondent's medical evidence, noting the applicant's diagnostic imaging showed no fractures and the psychological assessment relied heavily on self-reporting.

The Tribunal also found that the respondent had already paid the claimed IRB.

The application was dismissed.

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

The respondent denied several treatment plans, including requests for physiotherapy, occupational therapy, and various assistive devices such as a Kubota tractor, a lawn mower, and car repair tools.

As a preliminary issue, the adjudicator found the applicant was barred from disputing the treatment plan for the Kubota tractor under s. 55(1)2 of the Schedule because he failed to attend two reasonably necessary s. 44 insurer's examinations.

On the substantive issues, the adjudicator approved the physiotherapy treatment plan, finding it reasonable and necessary for pain relief despite the applicant's condition having plateaued.

The adjudicator also partially approved treatment plans for occupational therapy preparation time and knipex pliers to assist with car repairs.

The remaining claims for a mattress, a vehicle lift, an adjustable rolling creeper, and a John Deere lawn mower were dismissed for lack of sufficient medical evidence establishing their necessity.

The applicant sought various statutory accident benefits following a motor vehicle accident, including income replacement benefits (IRBs), attendant care benefits (ACBs), transportation costs, and a chronic pain assessment.

The Licence Appeal Tribunal dismissed the application in its entirety.

The Tribunal found the applicant failed to prove a substantial or complete inability to work to qualify for IRBs, noting she had returned to work and later received CERB due to pandemic-related job loss.

Claims for ACBs, transportation costs, and the chronic pain assessment were also dismissed for lack of supporting evidence and failure to meet the respective legal thresholds.

Consequently, claims for interest and a Regulation 664 award were denied.

The applicant sought statutory accident benefits, including a determination of catastrophic impairment and medical benefits for psychological and physiotherapy treatment, following a 2014 motor vehicle accident.

The respondent denied the claims, arguing the applicant's psychological issues were pre-existing and unrelated to the accident.

The Tribunal found that the applicant failed to meet his burden of proof, as he presented no medical evidence to support his claims, while the respondent's expert evidence established that his psychiatric condition predated the accident.

The application was dismissed in its entirety.

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

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

The Tribunal found that the applicant sustained psychological injuries, removing him from the MIG.

However, the Tribunal denied the physical therapy, chronic pain, and orthopaedic assessment plans due to a lack of contemporaneous evidence and failure to meet the criteria for chronic pain.

The Tribunal approved a social worker assessment plan as reasonable and necessary, awarding interest on that amount.

The applicant sought statutory accident benefits following a 2015 motor vehicle accident.

The Tribunal found the applicant was not entitled to an income replacement benefit because she failed to comply with section 57(2) of the Schedule by not engaging in recommended psychological treatment for her psychological impairments.

The Tribunal granted the claims for medical cannabis and occupational therapy services because the respondent failed to provide proper denial notices under section 38(8) of the Schedule.

The request for an electric mattress and elongated toilet was dismissed as the devices were found to be reasonable but not necessary.

A claim for chiropractic services was found payable directly to the treatment provider.

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

The respondent insurer raised a preliminary issue, arguing the applicant was barred from proceeding under s. 55 of the Schedule for failing to attend insurer's examinations.

The Tribunal found the applicant made himself reasonably available and was not barred.

On the substantive issues, the Tribunal found the accident directly caused the applicant's physical and psychological impairments.

The Tribunal granted entitlement to the disputed physiotherapy, chiropractic treatment, and an occupational therapy in-home assessment, finding them reasonable and necessary.

The claim for psychological treatment was dismissed due to lack of evidence that the applicant utilized previously approved treatment.

The Tribunal declined to order an award under Regulation 664, finding the insurer's conduct did not rise to the requisite level of unreasonableness.

The applicant was injured in a motor vehicle accident and sought ongoing income replacement benefits (IRBs) after the insurer terminated them.

The insurer argued the applicant's impairments were due to pre-existing degenerative disc disease and osteoarthritis.

The Tribunal found that the applicant suffered from chronic pain syndrome caused by the accident, applying the AMA Guides criteria.

Given her limited English, lack of higher education, and history of physically demanding work, the Tribunal concluded she met both the substantial inability test and the complete inability test.

The Tribunal ordered the insurer to pay the ongoing IRBs with interest.

The applicant was struck by a vehicle in a parking lot, sustaining crush injuries to her feet.

She sought $900 for chiropractic treatment to address low back and pelvic pain, which the respondent insurer denied on the basis that the pain was caused by pre-existing arthritis rather than the accident.

The Tribunal found that the applicant's altered gait from her foot injuries caused overcompensation resulting in low back pain, satisfying the 'but for' test for causation.

The Tribunal held the treatment was reasonable and necessary, ordering the respondent to pay the $900 plus interest, but denied the applicant's request for costs.

The applicant sought income replacement benefits (IRBs) following a motor vehicle accident.

The respondent insurer suspended the IRBs after the applicant failed to attend a scheduled orthopaedic insurer's examination (IE).

The applicant argued the IE was not reasonably necessary and sought payment of the withheld IRBs, an award, and interest.

The Tribunal found that the requested orthopaedic IE was reasonably necessary given new medical evidence (an MRI showing an annular tear) and that the applicant failed to provide a reasonable explanation for his non-attendance.

Consequently, the insurer was not required to pay IRBs for the period of non-compliance.

However, the Tribunal awarded the applicant $250 in costs due to the insurer's unreasonable and bad faith conduct in evading service of a summons for its adjuster.

The insurer's request for costs was denied.

The applicant sought statutory accident benefits for physiotherapy and chiropractic treatments following a motor vehicle accident.

The respondent insurer denied the treatments and brought a preliminary motion to strike portions of the applicant's reply submissions for improperly introducing new evidence.

The Tribunal partially granted the motion to strike, removing new arguments and evidence that should have been in the initial submissions.

On the substantive issues, the Tribunal found the physiotherapy treatment plan reasonable and necessary based on the applicant's credible self-reporting of pain relief, despite the medical assessors not explicitly recommending it.

The claim for the balance of the chiropractic treatment plan was dismissed as the applicant failed to prove that the proposed exercises required the supervision of a chiropractor.

The applicant sought various statutory accident benefits following a motor vehicle accident, including attendant care benefits and multiple treatment plans for psychological and physical injuries.

The Licence Appeal Tribunal denied the claim for attendant care benefits because the applicant failed to prove the expenses were incurred.

However, the Tribunal ordered the insurer to pay for several treatment plans, including a psychological assessment and physical therapy, because the insurer failed to provide proper medical reasons for its denials as required by section 38(8) of the Schedule.

The Tribunal also approved a chronic pain assessment and shockwave therapy based on medical evidence of ongoing pain, but denied other treatment plans for lack of evidence of reasonableness and necessity.

The claim for a special award was dismissed.

Following a reconsideration order, the Licence Appeal Tribunal redetermined the applicant's entitlement to an income replacement benefit (IRB).

The Tribunal found that the applicant suffered a substantial inability to perform the essential tasks of her pre-accident employment as a customer service representative due to chronic pain in her left arm and shoulder.

The Tribunal preferred the evidence of the applicant and her medical expert over the insurer's experts, noting that the applicant's ongoing pain and functional limitations were consistent with an inability to perform her work tasks.

The applicant was awarded IRBs of $341.96 per week for the disputed period, plus interest.

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

The Tribunal found the applicant was entitled to income replacement benefits for the first 104 weeks post-accident, as she suffered a substantial inability to perform the essential tasks of her pre-accident employment as a personal support worker.

However, she was not entitled to income replacement benefits beyond 104 weeks, as she failed to prove a complete inability to engage in any employment for which she was reasonably suited.

The Tribunal also partially approved a treatment plan for assistive devices, but denied other treatment plans for occupational therapy, rehabilitative therapy, and a massage therapy assessment.

The applicant's request for costs was denied.