Brett Todd

The applicant, who was catastrophically impaired following a motor vehicle accident, sought entitlement to various housekeeping, home maintenance, and massage therapy expenses, as well as a $277,895.75 treatment plan for assistive devices including a tractor and snow blower.

The Licence Appeal Tribunal dismissed the application in its entirety.

The Tribunal found the applicant failed to prove he normally performed the housekeeping tasks pre-accident, incurred the massage therapy and several assistive devices prior to submitting a treatment plan, and failed to demonstrate that the remaining assistive devices were reasonable and necessary.

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

The Licence Appeal Tribunal found insufficient medical evidence to support the exacerbation of pre-existing conditions or the presence of accident-related psychological impairments, placing minimal weight on a psychological assessment that relied solely on self-reporting.

The Tribunal concluded the applicant's injuries were predominantly minor, dismissing her claims for treatment plans beyond the $3,500 MIG limit and denying interest.

The applicant insurer sought repayment of $4,150.90 in income replacement benefits (IRB) paid to the respondent, alleging overpayment due to the respondent's wilful misrepresentation regarding her receipt of collateral benefits.

The respondent failed to participate in the written hearing.

The Tribunal found that the respondent committed wilful misrepresentation by failing to disclose collateral benefits from a second employer, which reduced her IRB entitlement.

The Tribunal ordered the respondent to repay the overpayment with interest, but denied the applicant's request for costs, finding the respondent's conduct did not rise to the level of bad faith required for a costs award.

The applicant sought a determination that she sustained a catastrophic impairment under Criterion 8 (mental or behavioural impairments) following a minor motor vehicle accident.

The Tribunal found that the applicant failed to establish that the accident was a necessary cause of her impairments, noting an extensive pre-accident medical history of physical and psychological disability that the applicant had minimized.

Furthermore, the Tribunal preferred the respondent's expert evidence, concluding that the applicant did not suffer a Class 4 marked impairment in three or more areas of functioning.

The application was dismissed.

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

The insurer held that her injuries fell within the Minor Injury Guideline (MIG) and denied treatment plans for a psychological pre-screen and assessment.

The Tribunal found that the applicant failed to prove on a balance of probabilities that her psychological impairments and headaches would not have occurred but for the accident.

The medical evidence showed a history of headaches pre-dating the accident and failed to establish a causal link between the accident and her symptoms.

The Tribunal concluded the applicant's injuries were predominantly minor and she remains subject to the $3,500 MIG limit, though she is entitled to any remaining funds within that limit.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to income replacement benefits (IRB) and medical benefits beyond the Minor Injury Guideline (MIG) limit due to chronic pain and psychological impairment.

The Licence Appeal Tribunal found that the applicant failed to prove her injuries fell outside the MIG, preferring the respondent's insurer examination reports which concluded she suffered only soft-tissue injuries.

As the MIG limit was exhausted, the disputed treatment plans were denied.

The Tribunal also dismissed the claim for IRB, finding insufficient evidence that the applicant suffered a substantial inability to perform the essential tasks of her employment or a complete inability to engage in any employment.

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

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

The applicant argued that the denial notices contravened s. 38(8) of the Schedule, which should mandate payment.

The Tribunal found that the denial notices were sufficient and met the statutory requirements.

Furthermore, based on the medical evidence, the applicant failed to prove his injuries fell outside the MIG.

As the MIG limit was functionally exhausted, the application for the disputed treatment plans was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the respondent's denial of two physiotherapy treatment plans and a portion of a psychological treatment plan.

The respondent argued the applicant was barred from proceeding with one physiotherapy claim due to non-attendance at an insurer's examination, but the Tribunal found no prejudice as the applicant attended a subsequent examination.

On the merits, the Tribunal dismissed the application, finding the physiotherapy plans were not proven reasonable and necessary given the lack of objective medical evidence and an unopposed independent medical examination.

The Tribunal also upheld the respondent's reduced hourly rate for the psychological services provided by an unregulated social worker.

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

The applicant passed away before the hearing, and no submissions were filed on his behalf or by his estate.

The Tribunal proceeded with a written hearing in the absence of the parties.

As no submissions were filed, the evidentiary burden was not met, and the application was dismissed.

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

The respondent insurer held that the applicant's injuries fell within the Minor Injury Guideline (MIG) and denied several treatment plans.

The applicant applied to the Licence Appeal Tribunal, arguing her injuries warranted removal from the MIG due to chronic pain and psychological impairment.

The Tribunal found that the applicant failed to demonstrate injuries outside the MIG, preferring the respondent's insurer examination reports over the applicant's medical evidence, which lacked objective support and was inconsistent with clinical records.

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

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 despite receiving notice and having a request for an extension denied.

The Tribunal found that the applicant failed to meet his evidentiary burden and dismissed the application.

The respondent's request for $1,000 in costs was denied, as the applicant's failure to file submissions did not amount to unreasonable, frivolous, vexatious, or bad faith conduct.

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

The matter proceeded to a written hearing before the Licence Appeal Tribunal.

Prior to the hearing, the applicant's legal counsel was removed from the record.

The applicant subsequently failed to file any written submissions.

The Tribunal proceeded with the hearing in the absence of the parties under the Statutory Powers Procedure Act.

Because the applicant provided no submissions, the Tribunal found she failed to meet her evidentiary burden to prove entitlement to the claimed benefits.

The application was dismissed.

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

The respondent denied the claims, and the applicant applied to the Licence Appeal Tribunal for resolution.

After the applicant's counsel withdrew, the applicant failed to file written submissions or participate in the written hearing despite receiving proper notice.

The Tribunal dismissed the application, finding that the applicant failed to meet her evidentiary burden to prove entitlement to the claimed benefits.

The respondent insurer requested a reconsideration of a Licence Appeal Tribunal decision that removed the applicant from the Minor Injury Guideline (MIG) and awarded three treatment plans due to deficient denial notices.

The Tribunal granted the reconsideration in part.

It found an error of law in removing the applicant from the MIG based solely on procedural notice contraventions, and upon reviewing the medical evidence, concluded the applicant did not establish chronic pain or psychological impairments warranting removal.

The Tribunal upheld the entitlement to two occupational therapy plans because the initial denial notices were sent only via HCAI and not directly to the applicant.

However, it reversed the entitlement to a physiatry assessment plan, finding the deficient notice was cured before the expense was incurred.

The 25 per cent award was varied to apply only to the two upheld treatment plans.

The applicant sought non-earner benefits and a physiotherapy treatment plan following a motor vehicle accident.

The Licence Appeal Tribunal excluded several of the applicant's medical reports because they were submitted eight months past the document exchange deadline, prejudicing the respondent.

On the merits, the Tribunal dismissed the claim for non-earner benefits, finding the applicant failed to provide sufficient evidence comparing her pre- and post-accident activities to establish a complete inability to carry on a normal life.

The Tribunal preferred the respondent's multidisciplinary insurer examination reports, which found no significant functional impairments.

The claim for the physiotherapy treatment plan was also dismissed as the applicant provided minimal argument or evidence to demonstrate it was reasonable and necessary.

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 participate after his legal counsel withdrew.

The Tribunal proceeded in the applicant's absence pursuant to section 7(2) of the Statutory Powers Procedure Act.

The application was dismissed because the applicant failed to meet his evidentiary burden to demonstrate entitlement to the claimed benefits.

The applicant insurer sought repayment of $5,184.61 in income replacement benefits paid to the respondent following a motor vehicle accident.

The insurer alleged the benefits were overpaid because the respondent returned to work immediately after the accident without notifying the insurer.

The respondent failed to participate in the written hearing.

The Tribunal found that the insurer met the notice requirements for repayment and proved that the respondent had resumed his pre-accident employment.

The Tribunal ordered the respondent to repay the overpaid benefits plus interest.

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

After his legal representative was removed from the record, the applicant failed to file written submissions for the hearing despite being granted additional time and receiving proper notice.

The Tribunal proceeded with the written hearing in the applicant's absence pursuant to s. 7(2) of the Statutory Powers Procedure Act.

The application was dismissed as the applicant failed to meet his evidentiary burden to demonstrate entitlement to the claimed benefits.

The applicant insurer sought repayment of $48,628.57 in Income Replacement Benefits (IRB) paid to the respondent, alleging the benefits were paid due to wilful misrepresentation and fraud.

The respondent failed to participate in the written hearing or comply with Tribunal orders to produce employment and income records.

The Tribunal drew an adverse inference from the respondent's non-compliance and relied on surveillance evidence showing the respondent working as a manual labourer while claiming IRB.

The Tribunal ordered the respondent to repay the full amount of the IRB plus interest pursuant to section 52 of the Statutory Accident Benefits Schedule.

The applicant insurer sought repayment of $3,328.34 in income replacement benefits (IRB) paid to the respondent, alleging wilful misrepresentation.

The respondent failed to participate in the written hearing.

The Licence Appeal Tribunal found that the respondent wilfully misrepresented his employment status by failing to disclose income from a second job while receiving IRB.

The Tribunal ordered the respondent to repay the IRB with interest, but declined to award costs to the insurer.