Theomarcus Giannou

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

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

The applicant argued that he suffered from chronic pain, radiculopathy, and fibromyalgia, which warranted removal from the MIG.

The Tribunal found that the medical evidence, including contradictory reports from the applicant's own physicians, did not establish on a balance of probabilities that the applicant's injuries required treatment outside the MIG.

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

The applicant sought accident benefits following a motor vehicle accident, claiming removal from the Minor Injury Guideline (MIG) due to physical injuries, a psychological impairment, and chronic pain.

The adjudicator found insufficient evidence to support removal from the MIG, preferring the respondent's psychological assessment over the applicant's because it was based on clinical testing and medical records rather than solely self-reported data.

The applicant also failed to establish a functional impairment from chronic pain.

The application for a psychological assessment, interest, and a section 10 award was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including attendant care benefits, occupational therapy, psychological counselling, kinesiology, and psychotherapy.

The Tribunal found the applicant was not entitled to attendant care benefits as they were not incurred.

However, the Tribunal approved the treatment plans for occupational therapy, psychological counselling, and virtual kinesiology, finding them reasonable and necessary based on the recommendations of various assessors and treatment providers.

The plan for psychotherapy by a registered nurse was denied as redundant.

The claim for a special award was dismissed, but interest was awarded on overdue benefits.

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 sought payment for a psychological treatment plan and argued the respondent's denial notices were non-compliant with s. 38(8) of the Schedule, thereby barring the respondent from relying on the MIG.

The Tribunal found the denial notices were compliant and provided principled medical reasons based on insurer's examinations.

As the applicant provided no substantive medical evidence or submissions to prove his injuries warranted removal from the MIG, the application for the treatment plan, interest, and an award was dismissed.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision denying his claim for statutory accident benefits.

The applicant argued the Tribunal erred in fact by finding he had not filed any evidence.

The Vice-Chair granted the reconsideration request, finding that the applicant had indeed filed a 1008-page document brief prior to the deadline.

However, upon reconsidering the matter, the Vice-Chair confirmed the original decision.

Because the applicant had only filed a document brief without any accompanying written submissions to explain how the evidence supported his claim, he failed to meet his evidentiary burden.

The Tribunal declined to sift through the voluminous record to make the applicant's case for him.

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

The matter proceeded to a written hearing, but the applicant failed to file any submissions or evidence.

The Tribunal proceeded with the hearing pursuant to section 7(2) of the Statutory Powers Procedure Act.

As the applicant bore the onus of proof and provided no evidence, the Tribunal found the applicant failed to demonstrate entitlement to removal from the Minor Injury Guideline or to the disputed medical benefits.

The application 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 he should be removed from the MIG due to chronic pain.

The Tribunal found the applicant did not establish on a balance of probabilities that he suffered from chronic pain with functional impairment, noting he did not meet three of the six criteria in the AMA Guides and had returned to work and normal household chores.

The application was dismissed.

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

The matter proceeded to a written hearing.

The applicant failed to file any submissions or evidence, despite receiving notice of the hearing and a reminder from the Tribunal.

Pursuant to section 7(2) of the Statutory Powers Procedure Act, the Tribunal proceeded with the hearing.

As the applicant bore the onus of proving entitlement and provided no evidence, the application was dismissed.

The applicant sought attendant care benefits and payment for two treatment plans following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding the applicant's testimony lacked credibility and the medical evidence, including surveillance and family physician records, demonstrated she did not require the claimed attendant care.

The Tribunal also denied the treatment plans, noting a lack of evidence for the first and finding the second sought unreasonable duplicate fees for catastrophic impairment assessments under section 25(5) of the Schedule.

Claims for an award and interest were consequently dismissed.

The applicant, a minor, sought various statutory accident benefits following a motor vehicle accident, including chiropractic services, physiotherapy, and several assessments.

The respondent insurer denied the treatment plans based on independent medical examinations.

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

The Tribunal accepted the respondent's medical assessments, which concluded the applicant sustained uncomplicated strains and had no functional impairments.

The Tribunal also found the respondent's denial notices complied with the requirements of section 38 of the Schedule.

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit (NEB) and medical/rehabilitation benefits outside the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to prove a complete inability to carry on a normal life for the NEB.

The Tribunal also held that the applicant's injuries were predominantly minor and that he did not establish removal from the MIG on the basis of pre-existing schizophrenia, chronic pain, or psychological impairments.

Consequently, the disputed treatment plans and interest were denied.

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

The insurer denied funding for a psychological assessment and psychological treatment, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and that the applicant failed to attend scheduled insurer's examinations (IEs).

The Tribunal found the applicant was not barred from proceeding because the insurer's notices requiring the IEs failed to provide sufficient medical reasons under s. 44(5) of the Schedule.

The Tribunal also removed the applicant from the MIG based on psychological diagnoses and ordered the insurer to pay for the disputed treatment plans because its denial letters failed to comply with the medical reasons requirement under s. 38(8).

The claim for a special award 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 Tribunal found that the applicant's physical injuries were predominantly minor soft tissue injuries that had largely resolved.

The applicant failed to establish that she suffered from chronic pain with functional impairments or a psychological condition that would warrant removal from the MIG.

As the MIG limits were exhausted, the claims for additional treatment plans, interest, and an award were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, arguing his chronic pain and psychological impairments warranted removal from the Minor Injury Guideline (MIG).

The Tribunal applied the AMA Guides criteria for chronic pain and found the applicant did not demonstrate sufficient functional impairment, as he maintained his pre-accident routines, work, and social life.

The Tribunal also found insufficient evidence of a psychological impairment, noting the applicant's own self-reporting denied significant anxiety or depression.

As the applicant remained within the MIG and the $3,500 limit was exhausted, the disputed treatment plans and claim for a special award were dismissed.

The applicant sought accident benefits following a motor vehicle accident, arguing her injuries fell outside the Minor Injury Guideline (MIG) due to chronic pain, a pre-existing condition, and psychological injuries.

The Tribunal found the applicant did not meet the burden of proving her injuries warranted removal from the MIG, noting her continued ability to work full-time and lack of compelling medical evidence.

As the applicant was subject to the MIG and the funding limit was exhausted, the claim for a chiropractic treatment plan and interest was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the respondent's determination that her injuries fell within the Minor Injury Guideline (MIG).

The applicant also claimed entitlement to a non-earner benefit, various treatment plans, and an award for unreasonable delay.

The Tribunal found that the applicant failed to provide compelling medical evidence to warrant removal from the MIG, either due to the severity of her injuries or a pre-existing condition.

The claims for a non-earner benefit and the disputed treatment plans were dismissed, as the applicant did not establish a complete inability to carry on a normal life or entitlement beyond the MIG limit.

The Tribunal also found the respondent's denial notices were compliant with the Schedule and denied the request for an award.

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

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

The applicant applied to the Licence Appeal Tribunal, arguing for removal from the MIG due to chronic pain and psychological impairments.

The Tribunal found that the applicant failed to meet the burden of proving chronic pain with a functional impairment under the AMA Guidelines, noting normal physical exams and lack of compelling evidence of functional decline.

The Tribunal also found insufficient evidence of a psychological condition, citing multiple assessments indicating symptom exaggeration and malingering.

The application was dismissed, and the applicant remained subject to the $3,500 MIG limit.

The applicant sought accident benefits following a motor vehicle accident, claiming removal from the Minor Injury Guideline (MIG) due to psychological impairment and chronic pain.

The Licence Appeal Tribunal found the applicant's evidence insufficient to establish a psychological condition or chronic pain with functional impairment, preferring the respondent's psychological assessment.

The Tribunal held that the applicant's injuries were predominantly minor, limiting her entitlement to the remaining $68.00 of the $3,500 MIG limit, and dismissed claims for further medical benefits and a special award.

The applicant requested a reconsideration of a previous Tribunal decision which found his injuries fell within the Minor Injury Guideline (MIG).

The applicant argued the Tribunal made errors of fact and law regarding his claims of a traumatic brain injury, chronic pain syndrome, and psychological impairment.

The Tribunal dismissed the request, finding no errors of law or fact that would have changed the outcome, and upheld the original decision that the applicant's injuries were minor.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision which found his injuries fell within the Minor Injury Guideline (MIG).

The applicant argued the Tribunal made errors of fact and law regarding his claims of a traumatic brain injury, chronic pain syndrome, and psychological impairment.

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

The Adjudicator confirmed that the original decision properly weighed the medical evidence, correctly applied the criteria for chronic pain, and appropriately assessed the applicant's psychological functionality.