Beverly Brooks

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

The respondent determined the applicant's injuries were minor and subject to the $3,500 funding limit under the Minor Injury Guideline (MIG), denying several treatment and assessment plans.

The applicant argued she suffered from psychological impairments and chronic pain.

The Tribunal found the applicant did not sustain a psychological impairment, preferring the respondent's psychological assessment over the applicant's evidence.

The Tribunal also found the applicant did not meet the criteria for chronic pain syndrome, preferring the respondent's musculoskeletal assessments over the family doctor's diagnosis.

As the injuries were minor and the funding limit was exhausted, the disputed treatment plans were not payable.

Claims for interest and costs were dismissed.

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

The respondent determined the applicant sustained a minor injury and was subject to the Minor Injury Guideline (MIG) limit of $3,500, denying several treatment plans.

The applicant argued his psychological impairments and chronic pain removed him from the MIG.

The Tribunal found the applicant's psychological evidence inconsistent and preferred the respondent's psychological assessment, which concluded the impairments were minor.

The Tribunal also found the applicant did not meet the criteria for chronic pain under the AMA Guides and had achieved full functional recovery.

As the applicant sustained a minor injury and had exhausted the MIG funding limit, the disputed treatment plans and interest were denied.

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

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

The Tribunal found that the applicant's physical and psychological injuries were predominantly minor, preferring the evidence of the respondent's experts over the applicant's experts.

Because the applicant's injuries fell within the MIG and the $3,500 limit had already been exhausted, the Tribunal concluded it was unnecessary to determine the reasonableness and necessity of the disputed treatment plans.

The application was dismissed.

The applicant was injured in a motor vehicle accident and sought income replacement benefits (IRB) and a psychological treatment plan.

The respondent insurer delayed paying the IRB for over a year, demanding documentation that was not required to determine eligibility, despite having received the necessary OCF-2 and OCF-3 forms.

The Tribunal found the respondent's conduct in withholding the IRB to be imprudent, stubborn, and inflexible, and ordered an award of 50% of the delayed IRB amount under s. 10 of Regulation 664.

The Tribunal also found the disputed psychological treatment plan to be reasonable and necessary, noting it was not duplicative of the applicant's psychiatric consultations, and ordered it payable with interest.

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

The Tribunal found that the applicant's injuries were predominantly minor and subject to the $3,500 MIG limit.

Relying on the respondent's expert assessments, which included validity testing indicating symptom magnification, the Tribunal concluded the applicant did not suffer from a psychological impairment or chronic pain syndrome.

The Tribunal approved two physiotherapy treatment plans and prescription expenses as reasonable and necessary within the MIG limit, but denied a third physiotherapy plan, a psychological assessment, and a chronic pain assessment.

Claims for an award for unreasonable delay were dismissed, though interest was awarded on the approved benefits.

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

The respondent initially placed the applicant in the Minor Injury Guideline but later removed him.

The Tribunal found that proposed chiropractic treatments were not reasonable and necessary, as the applicant had reached maximum medical recovery and past treatments provided little relief.

However, the Tribunal approved a chronic pain assessment, finding it reasonable and necessary because the applicant met the AMA Guides criteria for chronic pain syndrome and had been diagnosed with chronic pain by multiple practitioners.

Claims for a special award and costs were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to income replacement benefits (IRBs), a physiotherapy treatment plan, and an in-home assessment.

The Licence Appeal Tribunal found that the applicant failed to prove a substantial inability to perform the essential tasks of her pre-accident employment as a waitress, preferring the respondent's insurer's examination reports over the applicant's medical evidence.

Consequently, the claim for IRBs was denied.

The Tribunal also denied the in-home assessment, noting the applicant reported independence with activities of daily living.

However, the Tribunal approved the physiotherapy treatment plan as reasonable and necessary to address ongoing neck and back pain, and awarded interest on that plan.

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

The respondent initially placed her in the Minor Injury Guideline (MIG) but later removed her, approving some treatment plans.

At issue was the reasonableness and necessity of several chiropractic treatment plans, a chronic pain assessment, a functional ability evaluation, and a work site assessment.

The Tribunal found the chiropractic treatments and chronic pain assessment to be reasonable and necessary, preferring the evidence of the applicant's treating practitioners and chronic pain assessor over the respondent's orthopedic IE assessor.

However, the functional ability evaluation and work site assessment were denied as the applicant failed to provide submissions or establish their goals.

Interest was awarded on the approved plans.

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

The respondent raised preliminary issues, arguing the application should be statute-barred under s. 55 of the Schedule because the applicant failed to attend two scheduled psychological insurer's examinations.

The Tribunal found that the requested examinations were reasonably necessary and properly scheduled, but declined to bar the application.

Instead, the Tribunal exercised its discretion to stay the proceedings for 120 days to allow the applicant to attend the examination.

A secondary issue regarding late production of evidence was resolved by admitting the evidence but assigning it less weight.

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

The respondent had removed the applicant from the Minor Injury Guideline (MIG) due to psychological impairments but denied the physical treatment plan.

The Tribunal found that the applicant did not need to be removed from the MIG again for physical injuries, but still bore the burden of proving the treatment was reasonable and necessary.

Relying on the respondent's physiatrist assessment and drawing an adverse inference from the applicant's failure to produce clinical notes, the Tribunal concluded the chiropractic treatment plan was not reasonable and necessary.

The application was dismissed.

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

The Tribunal found that the applicant failed to provide sufficient medical evidence from specialists to prove she could not attain maximal recovery within the MIG or that she developed chronic pain syndrome or a psychological impairment.

Relying on the respondent's specialist assessments, the Tribunal concluded the applicant's injuries remained within the MIG.

As the $3,500 limit was exhausted, the disputed treatment plans, interest, and an award were denied.

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

The insurer had removed the applicant from the Minor Injury Guideline due to a pre-existing psychological condition but denied the specific treatment plans.

The Licence Appeal Tribunal found that the applicant failed to prove the treatments were reasonable and necessary, preferring the evidence of the insurer's physiatrist over the applicant's psychologist regarding physical injuries.

The Tribunal also noted the applicant's high level of physical activity, such as skiing and golfing, which contradicted a chronic pain condition.

The application was dismissed.