Kevin So

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 Tribunal found the applicant suffered a psychological impairment, specifically unspecified depressive disorder and PTSD, warranting removal from the MIG.

The Tribunal preferred the applicant's psychological assessment over the respondent's insurer examination.

However, the Tribunal denied the applicant's claims for physiotherapy, finding a lack of compelling contemporaneous medical evidence of physical impairment beyond soft tissue injuries.

A psychological assessment was approved at a reduced hourly rate for the psychotherapist, along with interest.

The applicant sought statutory accident benefits following a motor vehicle accident, arguing he should be removed from the Minor Injury Guideline (MIG) due to chronic pain and psychological injuries.

The Licence Appeal Tribunal found the applicant failed to establish chronic pain with functional impairment, noting his expert's report lacked corroborating medical records and did not clearly align with the AMA Guides criteria.

The Tribunal also rejected the applicant's psychological claims, preferring the respondent's expert who found a lack of objective information supporting a psychological impairment.

The application was dismissed, and the applicant remained subject to the MIG.

The applicant sought statutory accident benefits after falling from a Boomer Beast mobility scooter.

The respondent denied benefits, arguing the incident was not an 'accident' because the scooter was not an automobile.

The Tribunal applied the Adams and Grummett tests, finding the Boomer Beast is an automobile in ordinary parlance as it is designed for use on public roads.

However, the Tribunal dismissed the applicant's claim for a $2,486 attendant care assessment, finding insufficient evidence that the assessment was necessary to prepare an attendant care needs form.

The applicant, an intercity bus driver, was injured in a motor vehicle accident and sought post-104 income replacement benefits (IRBs).

The respondent denied the benefits, arguing the applicant's return to part-time work as a mail courier demonstrated she did not suffer a complete inability to engage in suitable employment.

The Tribunal found that the applicant's cognitive decline, photophobia, and reduced stamina rendered her unable to perform the highly responsible duties of an intercity bus driver.

Relying on the applicant's recent neurological and neuropsychological assessments, the Tribunal concluded her condition had deteriorated over time and she met the post-104 test as of September 27, 2023.

The applicant was awarded IRBs from that date onward, plus interest.

The applicant was involved in a motor vehicle accident and sustained a severe traumatic brain injury.

He applied to the Licence Appeal Tribunal after the respondent insurer denied his claims for catastrophic impairment, post-104 week income replacement benefits, and various treatment plans.

The Tribunal found that the applicant sustained a catastrophic impairment under Criterion 4, as his GOS-E assessment demonstrated a Lower Moderate Disability due to his inability to work and constant disruption to relationships.

The Tribunal also awarded post-104 week income replacement benefits, finding the applicant completely unable to engage in suitable employment due to cognitive and emotional impairments.

The claims for treatment plans were dismissed as the applicant failed to make submissions on their reasonableness and necessity.

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 were predominantly minor and that he failed to establish an accident-related psychological impairment warranting removal from the MIG.

The Tribunal preferred the respondent's psychological assessment over the applicant's, noting a lack of corroborating medical evidence.

As the applicant remained in the MIG and the funding limit was nearly exhausted, the disputed treatment plans were denied.

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 focused his arguments on alleged procedural errors by the respondent, claiming the respondent failed to provide proper medical reasons for denying the income replacement benefit (IRB) and treatment plans under sections 36(4) and 38(8) of the Schedule.

The Tribunal found that the applicant failed to provide substantive medical evidence to warrant removal from the MIG or entitlement to an IRB.

Furthermore, the Tribunal held that the respondent's denials were procedurally valid, as they requested specific medical information necessary to determine entitlement.

The application was dismissed.

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

The applicant applied to the Licence Appeal Tribunal for various treatment plans, the cost of a Disability Certificate, income replacement benefits (IRBs), interest, and an award.

The Tribunal found that the applicant's injuries were predominantly minor, noting that his accident-related complaints had resolved prior to a subsequent bicycle accident.

The Tribunal dismissed the claims for treatment plans as the applicant remained within the MIG limit.

The claim for IRBs was also dismissed because the applicant failed to meet his evidentiary burden and the evidence showed he had returned to work.

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

The applicant sought accident benefits following a motor vehicle collision.

The adjudicator found that the applicant's injuries warranted removal from the Minor Injury Guideline (MIG) due to chronic pain syndrome, satisfying several criteria under the AMA Guides.

However, the applicant's claims for a non-earner benefit and a chiropractic treatment plan were dismissed.

The adjudicator concluded that the applicant did not suffer a complete inability to carry on a normal life, as she retained significant functional capacity to engage in pre-accident activities.

The treatment plan was denied because the applicant failed to provide substantive evidence demonstrating it was reasonable and necessary.

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

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

The matter proceeded to a written hearing.

The applicant failed to file any written submissions.

Pursuant to section 7(2) of the Statutory Powers Procedure Act, the Tribunal proceeded without the applicant's participation.

The Tribunal found that the applicant failed to meet his evidentiary burden to demonstrate removal from the Minor Injury Guideline or entitlement to the disputed benefits.

The application was dismissed.

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

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

The insurer raised a preliminary issue that the application was statute-barred because it was filed beyond the two-year limitation period under section 56 of the Statutory Accident Benefits Schedule.

The Tribunal found that the insurer had issued valid denial notices for all disputed benefits, triggering the limitation periods.

As the application was filed after the limitation periods expired and the applicant provided no submissions to justify an extension, the Tribunal dismissed the application as statute-barred.

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 a pre-existing condition, chronic pain, and psychological impairments.

The Tribunal found the applicant failed to provide compelling medical evidence to support any of the grounds for removal.

The application was dismissed, and the applicant was limited to the remaining $24.49 balance of the MIG limit.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to various treatment plans for physical and psychological impairments.

The respondent denied the plans, arguing a lack of corroborating medical evidence and that certain costs, such as PPE, were administrative overhead.

The Tribunal found that the applicant failed to meet the burden of proving the treatment plans were reasonable and necessary, noting the absence of contemporaneous clinical notes from a family physician.

The Tribunal also held that PPE costs are captured by administrative overhead under the Professional Services Guideline.

The application was dismissed in its entirety.

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

The Licence Appeal Tribunal dismissed the application.

The Tribunal found the applicant was excluded from receiving a non-earner benefit under s. 31(1)(a)(ii) of the Schedule because she was driving with a suspended licence at the time of the accident.

The claims for treatment plans were also dismissed as the applicant failed to provide sufficient medical evidence to prove they were reasonable and necessary.

The appellant, who was deemed catastrophically impaired following a motor vehicle accident, appealed a Licence Appeal Tribunal (LAT) decision dismissing his claim for attendant care benefits.

The Divisional Court found that the LAT Vice-Chair erred in law by providing inadequate, conclusory reasons and conflating the test for 'reasonable and necessary' expenses with procedural non-compliance.

The court set aside the LAT decision and remitted the matter for a fresh hearing before a differently constituted tribunal.

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

The Licence Appeal Tribunal found that the applicant failed to provide compelling medical evidence of chronic pain with a functional impairment or a psychological condition caused by the accident.

The Tribunal preferred the respondent's independent medical and psychological evaluations, which concluded the injuries were minor and subclinical.

As the applicant remained subject to the MIG and the limits were exhausted, the claims for various treatment plans and assessments were dismissed.

The applicant was involved in a motor vehicle accident and sought an income replacement benefit (IRB) from the respondent insurer.

The Tribunal found that the applicant sustained an accident-related psychological impairment that caused a substantial inability to perform the essential tasks of her pre-accident employment as a grocery store cashier.

Furthermore, the Tribunal determined that this impairment caused a complete inability to engage in any reasonably suited employment past the 104-week mark, but that this complete inability resolved by June 2, 2023, when she was ready to return to work.

The applicant was awarded an IRB of $400 per week from October 4, 2020, to June 2, 2023, plus interest on overdue payments.

The applicant requested a reconsideration of a previous Tribunal decision which found his injuries were predominantly minor and subject to the Minor Injury Guideline (MIG).

The applicant alleged several errors of fact and law, including the Tribunal's assessment of evidence regarding a finger fracture and the standard of proof applied.

The adjudicator dismissed the request, finding that the alleged errors of fact were either not errors or would not have changed the result, and that there were no errors of law in the application of the standard of proof or causation tests.

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

The respondent denied treatment plans for psychological services, chiropractic services, and a neurological assessment on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant failed to demonstrate that her injuries warranted removal from the MIG.

As the proposed treatments fell outside the MIG limit, they were not reasonable or necessary, and no interest was payable.

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

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

The applicant claimed to have suffered a finger fracture and psychological impairments that warranted removal from the MIG.

The Tribunal found insufficient evidence that the finger fracture was caused by the accident and preferred the respondent's psychological assessment, which found no clinically significant psychological impairment.

The Tribunal concluded the applicant's injuries were predominantly minor and subject to the $3,500 MIG limit.

The disputed treatment plans for physiotherapy, psychological assessment, and orthopaedic assessment were denied as the applicant failed to prove they were reasonable and necessary.