Geoffrey Bogo

The applicant sought medical benefits for physiotherapy, chiropractic, and massage therapy services following a motor vehicle accident.

The respondent denied the treatment plan based on an insurer's examination.

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

The Tribunal preferred the evidence of the respondent's orthopedic surgeon, who concluded the applicant had reached maximum medical recovery and would not benefit from further facility-based treatment, over the applicant's medical records which showed limited improvement.

The applicant was injured in a motor vehicle accident and received income replacement benefits (IRBs) until the insurer terminated them, arguing his ongoing back pain was caused by post-accident weight gain rather than the accident.

The Tribunal found that the applicant's rapid weight gain and chronic pain were a result of the accident.

Relying on the applicant's medical experts, the Tribunal concluded the applicant met both the pre-104 week test of substantial inability to perform his pre-accident employment and the post-104 week test of complete inability to engage in suitable employment.

The applicant was awarded ongoing IRBs with interest, and the insurer's claim for repayment of benefits was dismissed.

The applicant requested a reconsideration of a Tribunal decision that denied his application for income replacement benefits following a motor vehicle accident.

The applicant alleged the Tribunal denied him natural justice and procedural fairness by ignoring or mischaracterizing his medical evidence.

The Associate Chair granted the reconsideration, finding that the original adjudicator committed significant errors of law and fact by failing to consider the applicant's evidence regarding his weight and by substantially mischaracterizing the medical reports of several doctors.

The application was ordered to be reheard by a different adjudicator.