Alim Ramji

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

The respondent denied the benefits, arguing the injuries fell within the Minor Injury Guideline.

The Tribunal scheduled a written hearing, but the applicant failed to file any written submissions or evidence, despite reminders.

The Tribunal proceeded with the hearing and dismissed the application, finding the applicant failed to meet his burden of proving his injuries were not predominantly minor or that he was entitled to the disputed treatment plans.

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, but the applicant failed to file any submissions or evidence.

The adjudicator found that the applicant failed to meet her burden of proving that her injuries fell outside the Minor Injury Guideline or that she was entitled to the disputed treatment plans and interest.

The application was dismissed.

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

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

The Tribunal found the applicant suffered from chronic pain with functional impairment, warranting removal from the MIG.

The Tribunal awarded an income replacement benefit (IRB) for the pre-104 week period, finding the applicant suffered a substantial inability to perform the essential tasks of her employment as a general labourer.

The Tribunal also approved treatment plans for psychological services and assessments, but denied plans for chiropractic and massage therapy.

Interest was awarded on overdue benefits.

The applicant sought entitlement to income replacement benefits (IRBs) and various medical and rehabilitation benefits following a motor vehicle accident.

The Tribunal found the applicant was entitled to pre-104-week IRBs due to psychological impairments, including driving anxiety, which caused a substantial inability to perform her pre-accident employment.

However, she was not entitled to post-104-week IRBs as she failed to prove a complete inability to engage in suitable employment.

The Tribunal also approved treatment plans for chiropractic and massage therapy but denied an orthopaedic assessment and an enhanced hourly rate for a psychotherapist providing psychological services.

The applicant sought entitlement to statutory accident benefits following a motor vehicle accident, specifically claiming unapproved balances for a psychological assessment and psychological services, as well as a treatment plan for chiropractic and massage therapy.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to prove the claimed costs for the psychological assessment were reasonable.

The Tribunal also held the applicant failed to justify paying a psychotherapist at a psychologist's hourly rate, and lacked sufficient medical evidence to establish that the chiropractic and massage therapy treatments were reasonable and necessary.

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

The Tribunal found that the applicant's psychological impairments, including anxiety and specific phobias, warranted removal from the Minor Injury Guideline (MIG).

However, the Tribunal dismissed the claims for outstanding balances on psychological treatment plans, finding that the provider was a qualifying psychotherapist and not entitled to the higher hourly rate reserved for psychologists under the Professional Services Guideline.

The application was dismissed.

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

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

The Licence Appeal Tribunal found that the applicant failed to prove on a balance of probabilities that he suffered from accident-related chronic pain or psychological impairments warranting removal from the MIG, preferring the evidence of the insurer's assessors.

The Tribunal also dismissed the claim for an income replacement benefit, finding insufficient evidence of the applicant's pre-accident self-employment as a social worker or inability to perform his duties as an Uber driver.

The application was dismissed.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied her claims for chiropractic, massage, and chronic pain treatment plans.

The applicant argued the Tribunal acted outside its jurisdiction and made errors of law and fact by determining she did not suffer from chronic pain and that her injuries fell within the Minor Injury Guideline.

The Tribunal dismissed the reconsideration request, finding it had jurisdiction to assess the severity of the injuries and the reasonableness of the treatment plans, and that it made no error in weighing the medical evidence to conclude the applicant had reached maximum medical recovery.

The applicant sought accident benefits following a motor vehicle accident, arguing his injuries warranted removal from the Minor Injury Guideline (MIG) due to pre-existing conditions, chronic pain, and psychological impairments.

The Tribunal found that the applicant's pre-existing degenerative disc disease did not preclude his recovery within the MIG.

Furthermore, the applicant failed to meet the AMA criteria for chronic pain and lacked evidence of psychological complaints to treating professionals.

As the applicant remained within the MIG and the treatment limit was exhausted, the disputed treatment plans and interest were denied.

The respondent's request for costs was also dismissed.

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

The applicant argued the Tribunal acted outside its jurisdiction, breached procedural fairness, and made errors of law and fact by rejecting a diagnosis of chronic pain and preferring the respondent's medical evidence.

The adjudicator dismissed the request, finding that the Tribunal acted within its jurisdiction to weigh the evidence and determine the severity of the injuries.

The adjudicator concluded that the applicant was attempting to relitigate the original findings and failed to meet the high threshold for reconsideration under Rule 18.2.

The applicant requested a reconsideration of a Tribunal decision which found his injuries were predominantly minor under the Statutory Accident Benefits Schedule and denied three treatment plans.

The applicant argued the adjudicator made errors of fact and law by giving little weight to his medical expert's diagnosis of chronic pain, and that the adjudicator's interpretation of the evidence raised a reasonable apprehension of bias.

The Tribunal dismissed the request, finding that weighing evidence is a core adjudicative function and that the adjudicator's analysis did not constitute an error of law or fact.

Furthermore, the applicant failed to meet the high threshold required to establish a reasonable apprehension of bias.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to various treatment plans for chiropractic, psychological, and chronic pain services.

The Licence Appeal Tribunal dismissed the application, finding that the cost of personal protective equipment was not covered, the proposed hourly rate for a psychotherapist was not justified, and the applicant had reached maximum medical recovery.

The Tribunal preferred the respondent's medical evidence, concluding that the applicant did not meet the criteria for chronic pain and that her ongoing knee issues were related to pre-existing conditions rather than the accident.

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

The respondent denied treatment plans for physiotherapy and a chronic pain assessment, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and its $3,500 limit, which was exhausted.

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

The adjudicator found the applicant sustained predominantly minor soft tissue injuries and failed to prove chronic pain with functional impairment or psychological impairment.

The adjudicator preferred the respondent's physiatry assessment over the applicant's medical evidence.

As the applicant remained within the MIG, the disputed treatment plans were denied, and no interest was payable.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including non-earner benefits, attendant care benefits, and various medical and rehabilitation benefits.

The Licence Appeal Tribunal dismissed the application in its entirety.

The adjudicator found the applicant to be a poor historian whose self-reported limitations were inconsistent with contemporaneous medical records.

The tribunal preferred the evidence of the respondent's assessors, concluding that the applicant did not suffer a complete inability to carry on a normal life, did not incur attendant care expenses, and failed to prove the claimed medical benefits were reasonable and necessary.

The applicant, a personal support worker struck by a motor vehicle as a pedestrian, sought statutory accident benefits including an income replacement benefit (IRB), a chronic pain assessment, and psychological treatment.

The Licence Appeal Tribunal dismissed the application.

The Tribunal found the applicant was barred from receiving an IRB for the initial period because she failed to submit a disability certificate until September 2019.

For the subsequent periods, she failed to prove a substantial or complete inability to work, as her family physician's notes indicated she was able to work after November 2018 and she provided no functional abilities evaluation.

The Tribunal also denied the chronic pain assessment and the disputed portion of the psychological treatment plan, finding them not reasonable or necessary based on the medical evidence.

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) and the $3,500 limit had been exhausted.

The applicant argued for removal from the MIG due to chronic pain, exacerbation of pre-existing neck and shoulder conditions, and a psychological impairment.

The Tribunal found that the applicant did not meet the AMA Guides criteria for chronic pain, lacked compelling evidence of exacerbated pre-existing conditions, and preferred the respondent's psychiatric assessment over the applicant's psychological report.

The Tribunal concluded the injuries were predominantly minor, and since the MIG limit was exhausted, the application for further treatment plans and assessments was dismissed.

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 she suffered from chronic pain that warranted removal from the MIG.

The Tribunal found that the applicant's initial injuries were soft tissue in nature and that the sudden onset of new symptoms nearly two years later was not causally linked to the accident.

The Tribunal preferred the evidence of the respondent's section 44 assessors over the applicant's evidence.

The Tribunal concluded the applicant failed to prove her injuries fell outside the MIG, and dismissed the claims for treatment plans, interest, and costs.

The applicant sought payment for psychological and orthopaedic assessments following a motor vehicle accident.

The respondent denied the benefits on the basis that they were not reasonable and necessary.

The Licence Appeal Tribunal found that the applicant failed to provide sufficient objective evidence to demonstrate that the assessments were reasonable and necessary as a result of the accident.

The application was dismissed.

The applicant requested a reconsideration of a decision finding that her accident-related impairments fell within the Minor Injury Guideline (MIG).

She argued the adjudicator erred in assessing her credibility, weighing the medical evidence regarding chronic pain and psychological impairments, and sought to introduce new medical records.

The adjudicator dismissed the request, finding no significant errors of law or fact that would have changed the outcome.

The adjudicator also declined to admit the new evidence, noting it was either available before the hearing or of limited value.

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

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

The applicant argued she suffered from chronic pain and a psychological impairment that removed her from the MIG.

The Tribunal found the applicant's self-reported symptoms inconsistent and preferred the evidence of the insurer's examiners.

The Tribunal concluded the applicant sustained predominantly minor injuries, and the disputed treatment plans for chronic pain, psychological, and driving anxiety assessments were not reasonable and necessary.