Nabila Majidzadeh

The applicant sought statutory accident benefits following a motor vehicle accident, including psychological services, a driving evaluation, and physiotherapy.

The respondent denied the treatment plans.

The Licence Appeal Tribunal found that the applicant failed to prove the treatment plans were reasonable and necessary.

The psychological services were not supported as the applicant did not recall previous sessions being helpful.

The driving evaluation was unnecessary as the applicant did not drive.

The physiotherapy was related to a significant pre-existing condition rather than the accident.

The application was dismissed.

The applicant sought entitlement to a medical benefit of $1,395.72 for chiropractic services following a motor vehicle accident, as well as an award for unreasonably delayed payments and interest.

The adjudicator found that the applicant had reached maximum medical improvement, relying on an insurer's examination and the applicant's own family physician's records, which recommended self-directed exercise rather than chiropractic treatment.

The adjudicator concluded the applicant failed to prove the treatment plan was reasonable and necessary.

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

The applicant sought statutory accident benefits for dental, physiotherapy, chiropractic, and massage therapy treatments following a motor vehicle accident.

The respondent denied the claims, arguing the treatments were for pre-existing conditions.

The Tribunal dismissed the application, finding the applicant failed to provide any medical evidence to support the claim that the treatments were reasonable and necessary or caused by the accident.

Claims for a section 10 award and interest were also dismissed.

The applicant sought medical benefits for chiropractic services and a psychological assessment following a motor vehicle accident.

The respondent denied the chiropractic treatment plans on the basis that they were not reasonable and necessary, and the applicant sought an award for delayed payment of the psychological assessment.

The Tribunal found that the applicant failed to prove the chiropractic treatments were reasonable and necessary, relying on the respondent's independent medical examination and the lack of support in the treating physician's records.

The Tribunal also dismissed the claim for an award, finding the respondent did not unreasonably delay approving the psychological assessment.

The applicant was injured in a motor vehicle accident while skateboarding and sought statutory accident benefits for chiropractic services, assistive devices, and psychological services.

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

The Licence Appeal Tribunal found that the applicant failed to provide sufficient medical evidence to support the need for the proposed treatments, noting that independent medical examinations concluded the applicant had reached maximal medical recovery.

The Tribunal also found no evidence that the assistive devices expense was incurred, and that the applicant had impliedly consented to the hourly rate paid for psychological services.

The application was dismissed.

The applicant requested a reconsideration of a decision denying two OCF-18s for passive therapy.

The applicant argued the adjudicator made a significant error of fact by not considering the impact of suspending passive rehabilitation on her pain relief and function.

The Vice-Chair dismissed the request, finding that the applicant was merely attempting to re-litigate the weight assigned to the medical evidence, particularly the preference for the insurer's section 44 examination report over the applicant's medical evidence.

The Vice-Chair confirmed that the original decision properly considered the evidence and the applicant's failure to meet her burden of proof.

The applicant was injured in a motor vehicle accident and sought removal from the Minor Injury Guideline (MIG) due to chronic pain and a suspected frozen shoulder, as well as entitlement to an income replacement benefit (IRB).

The Licence Appeal Tribunal found that the applicant's injuries were predominantly minor, as medical imaging was unremarkable and no definitive diagnosis outside the MIG was established.

The Tribunal also dismissed the claim for an IRB, finding insufficient objective evidence that the applicant suffered a substantial inability to perform the essential tasks of her pre-accident employment at a restaurant.

Claims for an award and interest were consequently dismissed.

The applicant sought statutory accident benefits for chiropractic treatment and a chronic pain assessment following a 2017 motor vehicle accident.

The insurer denied the treatment plans on the basis that they were not reasonable and necessary.

The Licence Appeal Tribunal found that the applicant failed to meet her burden of proving the treatments were reasonable and necessary, noting a lack of objective musculoskeletal impairment and evidence that the applicant had returned to normal activities.

The application was dismissed.

The applicant sought medical and rehabilitation benefits following a motor vehicle accident, which the respondent insurer denied.

The Licence Appeal Tribunal found that the applicant was entitled to the cost of a neurological assessment, as his treating physician diagnosed a nerve injury and the insurer's assessors lacked access to those medical records.

However, the Tribunal dismissed the claims for a chronic pain assessment, a Functional Ability Evaluation, psychological treatment, and transportation costs for an orthopaedic assessment, finding them not reasonable and necessary due to pre-existing conditions, lack of contemporaneous evidence, and unpersuasive expert reports.

The claim for a special award under Regulation 664 was also dismissed.

The applicant sought entitlement to statutory accident benefits for physiotherapy and chiropractic treatment plans following a 2017 motor vehicle accident.

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

The Tribunal preferred the evidence of the respondent's orthopaedic surgeon, who found no physical abnormalities and concluded the applicant had recovered from her minor soft tissue injuries, over the applicant's clinical notes and records which showed significant gaps in treatment and a failure to undergo recommended diagnostic imaging.

The applicant sought entitlement to the costs of three examinations (a Neurology Assessment, an E.E.G., and an MRI) following a motor vehicle accident, claiming he suffered a head injury causing headaches and pain.

The respondent denied the benefits, arguing the applicant's headaches were cervicogenic and related to a soft-tissue injury.

The Tribunal found no objective medical evidence of a neurological disability or impairment resulting from the accident.

Relying on the reports of the insurer's examiner and other specialists, which aligned with the family doctor's findings, the Tribunal concluded the examinations were not reasonable and necessary.

The application was dismissed.

The applicant sought entitlement to various statutory accident benefits, including treatment plans for an occupational therapy assessment, a functional abilities evaluation, a concussion assessment, and physical therapy, following a motor vehicle accident.

The adjudicator found that the applicant failed to provide objective medical evidence to support the treatment plans.

Relying on the respondent's insurer's examination report, which found the applicant had full range of motion and required no further facility-based treatment, the adjudicator concluded the disputed benefits were not reasonable and necessary.

The application was dismissed in its entirety.

The applicant, a cyclist injured in a motor vehicle accident, sought funding for a physical treatment plan and a chronic pain assessment under the Statutory Accident Benefits Schedule.

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

The Tribunal noted the physical treatment plan lacked support from treating practitioners at the time it was submitted, and the applicant did not meet the criteria for chronic pain syndrome under the AMA Guides to warrant a chronic pain assessment.

The applicant sought medical benefits for physiotherapy and psychological services 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 sustained predominantly minor soft tissue injuries and failed to prove on a balance of probabilities that he suffered from chronic pain or psychological impairments that would remove him from the MIG.

As the applicant was subject to the $3,500 funding limit, the disputed treatment plans and claim for interest were denied.

The applicant sought payment for a psychological treatment plan following a motor vehicle accident.

The insurer denied the plan, arguing it was not reasonable and necessary.

The Tribunal found that the applicant failed to demonstrate the treatment was reasonable and necessary, noting that the most recent psychological assessment revealed no diagnosable condition and that the applicant's current complaints appeared related to a subsequent accident.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including income replacement benefits (IRBs) and various medical and rehabilitation expenses.

The insurer denied the benefits, arguing the applicant suffered predominantly minor injuries subject to the $3,500 limit under the Minor Injury Guideline, which had been exhausted.

The Tribunal found the applicant did not suffer a substantial inability to perform the essential tasks of his employment and was therefore not entitled to IRBs.

Furthermore, the Tribunal concluded the applicant's injuries were predominantly minor, and since the $3,500 limit was exhausted, no further medical benefits were payable.

The application was dismissed.

The applicant was injured in a motor vehicle accident and sought medical benefits for chiropractic treatment outside the Minor Injury Guideline (MIG).

The applicant argued she suffered from chronic pain syndrome and a psychological impairment, relying on a chiropractor's report.

The Tribunal found the chiropractor's psychological diagnosis was outside his scope of expertise and unsupported by objective medical evidence.

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

The claims for additional chiropractic treatment and interest were dismissed.

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

The respondent denied the benefits and requested a preliminary issue hearing to determine if the applicant was barred from proceeding due to her failure to attend multiple insurer's examinations under s. 44 of the Schedule.

The Tribunal found that the respondent provided proper notice and the applicant failed to provide a reasonable explanation for missing six scheduled examinations.

Consequently, the applicant was barred from proceeding under s. 55 of the Schedule, and the application was dismissed.

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

The respondent denied the treatment plans on the basis that they were not reasonable or necessary.

The Licence Appeal Tribunal found that the applicant had likely reached maximal medical recovery for her physical injuries and that further passive treatment would provide negligible benefit.

The application was dismissed.

The applicant sought medical benefits for chiropractic services following a motor vehicle accident.

The respondent insurer denied the treatment plans, arguing the applicant's pain presentation was inconsistent and his physical injuries no longer required facility-based therapy.

The Tribunal found the applicant's self-reported pain and improvements credible, supported by psychological assessments indicating he was not feigning symptoms.

The Tribunal ordered the respondent to pay for the disputed medical benefits, excluding services incurred prior to the submission of the treatment plan, along with interest.