Laura C. Meschino

The applicant was injured in a motor vehicle accident and sought non-earner benefits, claiming a complete inability to carry on a normal life.

The respondent denied the benefits after an initial period of payment.

The adjudicator found that the applicant had significant pre-existing conditions, including avascular necrosis and hip pain, which already limited his pre-accident activities.

Applying the Heath test, the adjudicator concluded that the applicant failed to prove his accident-related impairments continuously prevented him from engaging in substantially all of his pre-accident activities.

The application was dismissed.

The applicant was injured in a motor vehicle accident and sought medical benefits beyond the $3,500 Minor Injury Guideline (MIG) limit.

The respondent denied the treatment plans, arguing the injuries were minor.

The Tribunal found insufficient evidence of psychological injuries or chronic pain that would warrant removal from the MIG.

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

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

The respondent insurer denied the benefits, arguing the applicant's injuries were predominantly minor and subject to the $3,500 limit of the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that the applicant's meniscal tear and unopposed psychological diagnoses warranted removal from the MIG.

However, the Tribunal only approved one treatment plan for $2,800, finding the applicant failed to provide sufficient evidence to prove the remaining claimed expenses were reasonable and necessary.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for a multi-disciplinary chronic pain management treatment plan and two physiotherapy treatment plans.

The adjudicator found the chronic pain management treatment plan to be reasonable and necessary, relying on the applicant's orthopaedic expert who established a direct causal relationship between the accident and the applicant's severe chronic pain.

However, the adjudicator dismissed the claims for the physiotherapy treatment plans, noting that the applicant had reached maximal medical recovery from a musculoskeletal perspective and that the chronic pain program already included multiple body sites therapy.

The applicant was awarded interest on the overdue chronic pain benefit.

The applicant was injured in a motor vehicle accident and sought payment for four physiotherapy treatment plans under the Statutory Accident Benefits Schedule.

Although the applicant had been removed from the Minor Injury Guideline for psychological reasons, the adjudicator found that the physical injuries were minor sprains and strains.

The applicant failed to provide objective medical evidence to prove the physical treatments were reasonable and necessary, relying only on a clinic letter and OHIP summary.

The adjudicator accepted the respondent's section 44 medical examination report, which concluded the applicant had reached maximum medical recovery physically.

The application was dismissed.