Adam Moftah

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to treatment plans beyond the $3,500 Minor Injury Guideline (MIG) limit due to post-concussion syndrome and dysthymic mood.

The Tribunal found the applicant failed to establish a causal connection between the accident and the alleged psychological or concussive conditions, noting a lack of pre-accident medical records and a significant gap before symptoms were reported.

Relying on the respondent's section 44 assessment, the Tribunal concluded the applicant sustained predominantly minor injuries.

The application was dismissed, and no further benefits or interest were awarded.

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

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

The Tribunal found that the medical evidence, including hospital records, family doctor notes, and an insurer's examination report, indicated the applicant sustained uncomplicated soft tissue injuries.

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

As the MIG limit applied, the disputed treatment plans were not payable.

The application was dismissed.

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

The respondent denied several treatment plans for physiotherapy, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and that one claim was statute-barred.

The Tribunal found that the claim for a February 2020 treatment plan was statute-barred as the application was filed beyond the two-year limitation period.

Furthermore, the Tribunal held that the applicant failed to prove on a balance of probabilities that he suffered from chronic pain with a functional impairment that would warrant removal from the MIG.

As the applicant remained in the MIG, the disputed treatment plans were not payable, though he was entitled to the remaining $529.55 of his MIG limit.

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 a psychological impairment.

The Tribunal found the applicant's psychological evidence unpersuasive due to provisional diagnoses and inconsistencies in reporting.

The Tribunal also found insufficient evidence that pre-existing conditions precluded recovery or that the applicant suffered from chronic pain with functional impairment.

The application was dismissed, and the injuries were deemed subject to the MIG limit.

The applicant sought statutory accident benefits following an alleged motor vehicle accident where she claimed to be struck as a pedestrian.

The respondent denied benefits and sought repayment, arguing the applicant materially misrepresented being involved in an accident due to inconsistent statements and a complex medical history.

The Tribunal found the applicant was involved in an accident and provided reasonable explanations for minor inconsistencies, dismissing the respondent's claim for repayment.

However, the Tribunal held that the applicant's substantive claims for benefits were statute-barred under s. 56 of the Schedule, as she failed to dispute the denials within the two-year limitation period and did not provide evidence to justify an extension under s. 7 of the LAT Act.

The application was dismissed.

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

The respondent denied benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued she suffered from physical injuries and chronic pain that warranted removal from the MIG.

The Tribunal found that the medical evidence, including records from the applicant's family physician and a physiatry assessment, supported a diagnosis of minor soft tissue injuries.

The applicant failed to provide sufficient evidence of chronic pain or functional impairment.

The application was dismissed, and the disputed treatment plans and interest 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 argued for removal from the MIG based on pre-existing conditions, chronic pain, and psychological impairments.

The Tribunal found that the applicant failed to provide compelling medical evidence that her pre-existing conditions prevented maximal medical recovery, or that she suffered from chronic pain with functional impairment or a psychological condition warranting removal.

The application for disputed treatment plans and interest was dismissed.

The applicant sought income replacement benefits, medical benefits, interest, and a special award following a motor vehicle accident.

The Licence Appeal Tribunal dismissed all claims.

The Tribunal found the applicant failed to prove a substantial inability to perform the essential tasks of his employment, noting inconsistencies in his medical records, a failure to report pre-accident income, and persuasive insurer examination reports.

The claims for chiropractic, psychological, and occupational therapy treatment plans were also dismissed because the applicant failed to submit the plans into evidence and did not establish that the treatments were reasonable and necessary.

The applicant sought statutory accident benefits following a rear-end motor vehicle collision.

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

The adjudicator found that the medical evidence, including hospital records and an insurer's examination, demonstrated only uncomplicated soft-tissue injuries.

As the applicant failed to prove his injuries fell outside the MIG, he was not entitled to the disputed treatment plans exceeding the $3,500 limit.

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

The Tribunal first addressed preliminary issues, finding that the applicant's claim for a $4,031.07 treatment plan was statute-barred for missing the two-year limitation period under s. 56 of the Schedule.

The Tribunal denied the respondent's request for costs and allowed the applicant's late-filed medical records into evidence.

On the substantive issues, the Tribunal held that the applicant failed to prove his injuries fell outside the Minor Injury Guideline (MIG) or that a pre-existing injury precluded his recovery within the MIG.

Consequently, the applicant was not entitled to the disputed physiatry assessment, interest, or a special award.

The application was dismissed.

The applicant sought a determination of catastrophic impairment and entitlement to income replacement benefits (IRB), attendant care benefits (ACB), and various treatment plans following a 2018 motor vehicle accident.

The Tribunal found the applicant did not meet the 55% whole person impairment threshold under Criterion 7, concluding his combined physical and mental impairment rating was 40%.

The Tribunal also found the applicant failed to prove a complete inability to engage in suitable employment, dismissing the claim for post-104-week IRB.

As the applicant was not catastrophically impaired and had exhausted non-catastrophic limits, the claims for ACB and treatment plans were also dismissed.

The applicant sought entitlement to statutory accident benefits for chiropractic, physiotherapy, and other goods and services following a motor vehicle accident.

The respondent denied the treatment plans, arguing the ongoing pain symptoms were driven by unrelated medical issues or pre-existing conditions, specifically obesity.

The Tribunal found that the applicant had not demonstrated the treatment plans were reasonable and necessary, noting a lack of progress despite significant prior facility-based treatment.

The Tribunal accepted the evidence of the respondent's section 44 assessors over the applicant's treating practitioners.

The application was dismissed.

The applicant sought entitlement to various medical and rehabilitation benefits under the Statutory Accident Benefits Schedule following a motor vehicle accident, including a functional abilities evaluation, chiropractic services, physiotherapy, massage therapy, and occupational therapy.

The respondent insurer denied the benefits.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to meet her burden of proving the proposed treatments were reasonable and necessary.

The Tribunal relied on the respondent's section 44 medical assessments, which indicated the applicant had returned to work and was functional in her activities of daily living, and noted a lack of objective medical evidence from the applicant to support the need for ongoing passive facility-based treatment.

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

The respondent denied the physiotherapy plans on the basis that the applicant's soft tissue injuries had resolved and she had reached maximum medical recovery, and partially approved the psychological plan.

The Tribunal found that the applicant failed to prove the physiotherapy plans were reasonable and necessary, preferring the evidence of the respondent's section 44 assessors.

The Tribunal also upheld the respondent's partial approval of the psychological plan as a reasonable approach given the applicant's uncertain prognosis.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident in 2016.

The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) limit of $3,500.

The applicant argued she suffered from chronic pain and psychological symptoms warranting removal from the MIG.

The Tribunal found the applicant's injuries were predominantly minor soft tissue injuries, relying on insurer examination reports that found no objective evidence of ongoing accident-related impairment.

The Tribunal concluded the applicant did not establish chronic pain with functional impairment or a psychological condition sufficient to remove her from the MIG.

The application for disputed treatment plans and interest was dismissed.

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 sought statutory accident benefits following a motor vehicle accident.

The respondent denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant failed to establish that his injuries warranted removal from the MIG, noting a lack of evidence of chronic pain syndrome or functional impairment.

As the MIG limits were exhausted, the disputed treatment plans were not payable and the application was dismissed.

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

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

The Tribunal found the applicant failed to prove she sustained a concussion or chronic pain that would remove her from the MIG.

Furthermore, the applicant failed to provide the disputed treatment plans or sufficient medical evidence to prove they were reasonable and necessary.

The appeal was dismissed in its entirety.

The applicant sought statutory accident benefits following a 2015 motor vehicle accident, including attendant care benefits and funding for three medical assessments.

The Tribunal dismissed the claim for attendant care benefits because the applicant was not catastrophically impaired and the 104-week post-accident period had expired.

The claims for an orthopedic and home site assessment were dismissed due to a lack of supporting medical evidence.

The respondent conceded the neuropsychological assessment was reasonable and necessary, which the Tribunal ordered, but no interest was awarded as the expense had not been incurred.