A. Bryn Copp

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

The adjudicator found that the applicant's physical and psychological injuries were predominantly minor and did not warrant removal from the Minor Injury Guideline (MIG).

The applicant's claim for income replacement benefits was dismissed as she failed to prove a substantial inability to perform the essential tasks of her employment.

However, the adjudicator found that the respondent's denial notices for two treatment plans were non-compliant with s. 38(8) of the Schedule, rendering the respondent liable to pay the incurred expenses under s. 38(11).

Claims for accounting reports and an award for unreasonable delay were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident but was denied by the respondent insurer on the basis that the injuries fell within the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG due to chronic pain, relying on their family physician's clinical notes and records to meet the AMA Guides criteria.

The Tribunal found the medical evidence insufficient to establish excessive dependence on health care providers, use of prescription drugs beyond recommended duration, or failure to restore pre-injury function.

The Tribunal concluded the applicant's injuries were predominantly minor, dismissing the claims for chiropractic treatment plans and interest.

The applicant sought statutory accident benefits following a motor vehicle accident, including income replacement benefits (IRBs), medical benefits, and catastrophic assessment costs.

The Licence Appeal Tribunal dismissed the application.

The Tribunal found the applicant was not entitled to pre-104-week IRBs because she failed to prove a substantial inability to perform her pre-accident employment, noting she was on employment insurance for pre-existing conditions prior to the accident and had indicated she did not intend to return to her job.

The claim for post-104-week IRBs was also dismissed as the applicant provided no evidence of a complete inability to engage in suitable employment.

Claims for outstanding treatment plan balances, including provider travel time and comprehensive file reviews, were denied as the applicant failed to establish they were reasonable and necessary or payable under the Schedule.