Anita Sol-Edeigba

The applicant, a minor injured in a motor vehicle accident, sought medical rehabilitation benefits for chiropractic services.

The insurer denied the treatment plan on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit had been exhausted.

The Tribunal found that the applicant's injuries, diagnosed as lumbar and thoracic sprains and strains, met the definition of minor injuries under the Schedule.

The applicant failed to provide compelling medical evidence of a pre-existing condition, psychological impairment, or chronic pain that would warrant removal from the MIG.

The application was dismissed.

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

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

The Tribunal found that the applicant's pre-existing insomnia and mild obstructive sleep apnea, which were exacerbated by the accident, prevented her from achieving maximal recovery within the MIG.

The applicant was removed from the MIG and awarded funding for a psychological assessment, psychotherapy services, and a psychiatric assessment at a reduced rate, along with interest on overdue benefits.

One duplicative psychological assessment was denied.

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

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

The applicant applied to the Licence Appeal Tribunal, claiming removal from the MIG due to chronic pain and psychological impairment.

The Tribunal found that the applicant failed to provide compelling medical evidence to support removal from the MIG.

As the MIG limits were exhausted, the applicant was not entitled to the disputed psychological assessment or medication expenses.

The application was dismissed, and claims for interest and an award were denied.

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

The respondent insurer denied a $2,460 treatment plan for an orthopedic assessment, arguing the applicant's injuries were predominantly minor and subject to the $3,500 limit under the Minor Injury Guideline (MIG).

The Tribunal found that the applicant had developed chronic pain syndrome, satisfying four of the six criteria under the AMA Guides, which warranted removal from the MIG.

The Tribunal concluded the proposed orthopedic assessment was reasonable and necessary, ordering the respondent to pay the treatment plan amount plus interest.

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

The Licence Appeal Tribunal found that the applicant failed to establish chronic pain with functional limitations, noting she did not meet the AMA Guides criteria and continued to work full-time.

The Tribunal preferred the respondent's medical and psychological experts, who found no objective evidence of non-minor physical or psychological impairments and noted symptom over-reporting.

The Tribunal concluded the applicant's injuries were predominantly minor and subject to the $3,500 MIG limit, ordering that any remaining funds within that limit be payable for incurred treatments, with interest.

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

The Tribunal found that the applicant's ongoing complaints were consistent with pre-existing issues from a prior accident and that he did not meet the criteria for chronic pain under the AMA Guides.

The Tribunal concluded the applicant suffered predominantly minor injuries, and having exhausted the MIG limits, he was not entitled to the disputed treatment plan or interest.

The applicant sought payment for a chiropractic treatment plan totaling $3,447.50 following a motor vehicle accident.

The applicant argued the respondent failed to comply with statutory notice requirements under the Schedule.

The Tribunal found the respondent's notices were compliant and provided sufficient medical reasons for requesting an insurer's examination.

Relying on the respondent's medical assessments, which concluded the applicant sustained uncomplicated soft tissue injuries and had reached maximum medical improvement, the Tribunal determined the proposed treatment was not reasonable and necessary.

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 for removal from the MIG based on a pre-existing condition and chronic pain.

The Tribunal found that the applicant's injuries, including degenerative changes, were predominantly minor.

The Tribunal also found insufficient evidence of chronic pain syndrome or functional impairment to warrant removal from the MIG under the AMA Guides criteria.

Consequently, the disputed treatment plans for physiotherapy and an orthopaedic assessment were deemed not reasonable and necessary, and the claims for benefits and interest were dismissed.