Brett Todd

The respondent insurer requested a reconsideration of a decision awarding the applicant income replacement benefits and two treatment plans.

The insurer argued the Tribunal reversed the evidentiary onus, misapplied the legal test for benefits, and made erroneous findings of fact regarding validity testing.

The Tribunal dismissed the request, finding that it had properly weighed the totality of the medical evidence without reversing the onus, and that any omissions regarding validity testing did not meet the high threshold for reconsideration.

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 four treatment plans for chiropractic and psychological services because the $3,500 limit had been exhausted.

The Tribunal found that the applicant failed to demonstrate chronic pain or psychological impairments warranting removal from the MIG, preferring the insurer's medical examinations over the applicant's evidence.

The application was dismissed, and no benefits or interest were awarded.

The applicant sought $1,977.05 for a physiotherapy treatment plan following a motor vehicle accident.

The respondent denied the plan.

The Tribunal found that the applicant failed to meet her burden of proving the treatment was reasonable and necessary, as she did not provide sufficient specific medical evidence linking her ongoing symptoms to the proposed treatment.

The Tribunal preferred the respondent's orthopedic assessment, which concluded the applicant had reached maximal medical improvement.

The application was dismissed.

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

The matter was scheduled for a written hearing, but the applicant failed to file any submissions or evidence by the required deadlines.

The respondent also filed no submissions but brought a motion to dismiss the application as abandoned.

The Tribunal proceeded in the absence of the parties under the Statutory Powers Procedure Act and dismissed the application, finding that the applicant failed to meet his evidentiary burden to prove entitlement to the claimed benefits.

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

The matter proceeded to a written hearing.

The applicant failed to file any written submissions or evidence in accordance with the Tribunal's orders.

The respondent filed a motion to dismiss the application.

The Tribunal found that the applicant failed to meet his evidentiary burden to demonstrate entitlement to the claimed benefits.

The application was dismissed.

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

The insurer held the applicant within the Minor Injury Guideline (MIG) and denied claims for non-earner benefits (NEB) and various treatment plans.

The Licence Appeal Tribunal found that the applicant failed to provide sufficient medical evidence to demonstrate chronic pain or a pre-existing condition that would warrant removal from the MIG.

Furthermore, the applicant did not meet the test for NEB, as evidence showed he maintained his typical daily routine and full-time employment post-accident.

The application was dismissed.

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

After her legal representative withdrew, the applicant failed to file any written submissions or evidence for the scheduled written hearing.

The Tribunal found that proper notice had been given under the Statutory Powers Procedure Act and proceeded in the parties' absence.

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

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that found her injuries fell within the Minor Injury Guideline (MIG) and denied two treatment plans.

The applicant argued the Tribunal breached procedural fairness by disputing medical diagnoses without contrasting opinions and ignoring reply submissions, and made errors of law regarding the burden of proof for chronic pain.

The Vice-Chair dismissed the request, finding no breach of procedural fairness as the adjudicator was entitled to weigh the medical evidence and was presumed to have reviewed all submissions.

While the adjudicator erred in stating the applicant had to prove chronic pain was not caused by soft-tissue injuries, this error would not have changed the outcome given the other reasons for rejecting the chronic pain diagnosis.

The applicant insurer sought repayment of medical benefits and a declaration barring the respondent from income replacement benefits, alleging the respondent wilfully misrepresented his address to secure a lower premium and staged the accident.

The respondent failed to participate in the written hearing.

The Tribunal found the respondent provided a falsified lease and bank statement to misrepresent his address, which constituted a material misrepresentation.

The Tribunal ordered the respondent to repay $2,315.00 in medical benefits with interest and barred him from receiving income replacement benefits.

The insurer's request for costs was denied.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the respondent's denial of an income replacement benefit, a physiotherapy treatment plan, and the application of the Minor Injury Guideline.

The matter proceeded to a written hearing.

The applicant failed to file initial written submissions and evidence in accordance with the Tribunal's orders.

Consequently, the Tribunal found the applicant failed to meet her evidentiary burden and dismissed the application.

The respondent's request for costs was denied, as the applicant's mere failure to file submissions did not constitute 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.

The applicant failed to file any written submissions or evidence in accordance with the Tribunal's orders and notices.

The Tribunal found that it had met its notice obligations under the Statutory Powers Procedure Act and proceeded in the applicant's absence.

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

The matter proceeded to a written hearing.

The applicant's legal representative withdrew prior to the hearing, and the self-represented applicant failed to file any written submissions or evidence.

The Licence Appeal Tribunal found that the applicant received proper notice and proceeded in his absence under the Statutory Powers Procedure Act.

The application was dismissed as the applicant failed to meet his evidentiary burden.

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 despite receiving proper notice and multiple reminders from the Tribunal.

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

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

The applicant sought non-earner benefits following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to submit a completed disability certificate (OCF-3) prior to the end of the claimed entitlement period, contrary to s. 36(2) of the Schedule.

Furthermore, the applicant failed to meet her evidentiary burden to demonstrate a complete inability to carry on a normal life, as she did not provide specific arguments or references to the evidence connecting her impairments to her pre- and post-accident activities.

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 written submissions or evidence in accordance with the Tribunal's orders.

Consequently, the Tribunal dismissed the application, finding that the applicant failed to meet her evidentiary burden.

The respondent's request for costs due to the applicant's failure to file submissions was denied, as the conduct did not rise to the level of being unreasonable, frivolous, vexatious, or in bad faith.

The applicant sought statutory accident benefits following a motor vehicle accident, including an income replacement benefit and several physiotherapy treatment plans.

The matter proceeded to a written hearing.

Neither the applicant nor the respondent filed written submissions or evidence by the deadlines established in the Case Conference Report and Order and the Notice of Written Hearing.

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

The Tribunal found that the applicant failed to meet her evidentiary burden to demonstrate entitlement to the claimed benefits.

The application was dismissed.

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

The respondent insurer determined the applicant's injuries fell within the Minor Injury Guideline (MIG) and denied a treatment plan for chiropractic services.

The applicant applied to the Licence Appeal Tribunal, arguing he suffered from chronic pain warranting removal from the MIG.

The Tribunal found the applicant failed to provide compelling medical evidence, such as clinical notes or a chronic pain diagnosis, to challenge the MIG determination.

The Tribunal held the applicant remained within the MIG and was only entitled to the remaining balance of the $3,500 limit.

The respondent's request for costs was denied as the applicant's failure to meet his evidentiary burden did not amount to unreasonable or frivolous conduct.

The insurer applied to the Licence Appeal Tribunal for repayment of an income replacement benefit (IRB) overpayment of $990.02, alleging the respondent wilfully misrepresented her employment status.

The respondent failed to participate in the written hearing.

The Tribunal found that the respondent's silence regarding her return to work constituted wilful misrepresentation.

The Tribunal ordered the respondent to repay the $990.02 overpayment plus interest.

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

After failing to attend two case conferences and failing to file written submissions or evidence for the written hearing, the Licence Appeal Tribunal proceeded in the applicant's absence.

The Tribunal dismissed the application, finding the applicant failed to meet his evidentiary burden to demonstrate entitlement to the claimed benefits.

The respondent's request for costs was denied because it failed to provide the required particulars and amount requested.

The applicant was involved in a motor vehicle accident and received income replacement benefits (IRBs) from the respondent insurer.

The applicant later withdrew his claims, leaving only the insurer's claim for repayment of IRBs and interest.

The applicant failed to participate in the written hearing.

The Tribunal found that the applicant had returned to work on October 26, 2020, but continued to receive IRBs until December 2, 2020.

The Tribunal ordered the applicant to repay the overpaid amount of $2,114.29 plus interest, as the insurer had provided proper notice and the overpayment resulted from the applicant's failure to promptly notify the insurer of his return to work.