Claudette Leslie

The applicant sought income replacement benefits (IRBs) following a motor vehicle accident.

The respondent insurer denied the benefits after an insurer's examination found no residual physical impairments.

The Tribunal found that the applicant failed to prove on a balance of probabilities that she suffered a substantial inability to perform the essential tasks of her employment as a cashier.

The Tribunal relied on the objective findings of the respondent's physiatrist and noted the applicant had returned to work and travelled extensively post-accident.

The application for IRBs, a special award, and interest was dismissed.

The respondent's request for costs was also dismissed.

The applicant was injured in a rear-end motor vehicle accident and sought statutory accident benefits.

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

The Licence Appeal Tribunal found that the applicant's physical injuries had developed into chronic pain, removing her from the MIG.

However, the Tribunal dismissed the claim for a non-earner benefit, finding the applicant was not continuously prevented from engaging in substantially all of her pre-accident activities.

The Tribunal approved treatment plans for a chronic pain program and assessment as reasonable and necessary, but denied claims for a psychological assessment and other medical expenses due to a lack of evidence of psychological impairment and failure to submit proper treatment plans.

The applicant, a 15-year-old pedestrian, was struck by a slow-moving vehicle and sought statutory accident benefits, including a non-earner benefit (NEB), medical and rehabilitation benefits, and the cost of a catastrophic impairment assessment.

The insurer denied the benefits.

The Tribunal found that the applicant was not entitled to the NEB, as she failed to prove that her accident-related injuries continuously prevented her from engaging in substantially all of her pre-accident activities, noting she successfully completed high school and transitioned to university.

The Tribunal partially approved the physiotherapy and psychological treatment plans, finding them reasonable and necessary, but denied transportation costs.

The request for a catastrophic impairment assessment was dismissed due to a lack of supporting medical evidence indicating a reasonable apprehension of catastrophic impairment.

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

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

The Licence Appeal Tribunal found that the applicant's injuries fell outside the MIG due to the development of chronic pain.

However, the Tribunal dismissed the claim for income replacement benefits, finding the applicant was not substantially unable to perform the essential tasks of her employment as a retail sales associate.

The Tribunal approved a $3,456 physiotherapy treatment plan as reasonable and necessary, but denied the applicant's request for a special award under Regulation 664, finding the insurer did not act unreasonably.

The applicant sought statutory accident benefits following a rear-end motor vehicle accident.

The respondent denied certain treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and that one claim was statute-barred.

The Tribunal found that the claim for $2,387.89 was statute-barred as it was filed beyond the two-year limitation period and the applicant failed to establish reasonable grounds for an extension under s. 7 of the LAT Act.

The Tribunal also held that the applicant's injuries were predominantly minor, as he failed to prove that his chronic pain or psychological issues removed him from the MIG, especially given an intervening workplace head injury.

However, the Tribunal found a treatment plan for $2,317.34 to be reasonable and necessary, payable up to the remaining balance of the $3,500 MIG limit.

The applicant's request for costs was dismissed.

The applicant was injured in a rear-end motor vehicle accident and sought medical and rehabilitation benefits beyond the $3,500 Minor Injury Guideline (MIG) limit, arguing that a pre-existing clavicle fracture was exacerbated, leading to chronic pain and psychological impairments.

The adjudicator found that the applicant failed to provide compelling evidence of functional impairment or disability resulting from chronic pain, noting that he continued to work and travel, and did not meet the criteria under the AMA Guides.

The adjudicator concluded that the applicant's injuries were predominantly minor and subject to the MIG limit.

As the MIG limit had been exhausted, the disputed treatment plans were denied and the application was dismissed.

The respondent insurer requested a reconsideration of a decision finding that the applicant's injuries fell outside the Minor Injury Guideline (MIG) due to a pre-existing condition that prevented maximum medical recovery.

The insurer argued there was insufficient evidence of a pre-existing condition and that the adjudicator misapplied the MIG test.

The adjudicator dismissed the request, finding that the original decision relied on sufficient medical evidence of pre-accident back and shoulder pain, and correctly applied the test for exemption from the MIG treatment limits.

The insurer failed to prove a significant error of law or fact.

The applicant, a convenience store owner and cashier, sought income replacement benefits (IRBs) following a motor vehicle accident.

The respondent insurer terminated the benefits after eight months.

The Licence Appeal Tribunal found that the applicant failed to prove she suffered a substantial inability to perform the essential tasks of her employment.

Medical evidence, including insurer examinations, indicated she retained reasonable physical function and her essential tasks were primarily administrative or light physical work.

The application was dismissed.

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

The respondent insurer denied several treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) $3,500 limit.

The Licence Appeal Tribunal found that the applicant's pre-existing physical conditions, including chronic back pain and degenerative disc disease, prevented her from achieving maximal medical recovery within the MIG limits.

Consequently, the Tribunal approved four physiotherapy treatment plans as reasonable and necessary for ongoing pain relief.

However, the Tribunal dismissed claims for psychological services and a mental health assessment, finding that the applicant's psychological issues were primarily related to pre-existing workplace problems and that she had successfully returned to driving.

Interest was awarded on the overdue physiotherapy payments.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming costs for an orthopaedic assessment, a functional abilities evaluation, and psychological treatment.

The respondent insurer denied the benefits, relying on its own independent medical examinations.

The Licence Appeal Tribunal found that the orthopaedic assessment and psychological treatment were reasonable and necessary, noting the applicant's ongoing chronic pain and psychological symptoms, which were exacerbated by the accident.

The Tribunal dismissed the claim for the functional abilities evaluation, finding it redundant given the orthopaedic assessment.

The Tribunal also dismissed the applicant's claim for a special award, finding the insurer did not unreasonably withhold or delay payments.

The applicant was involved in a rear-end motor vehicle accident and sought statutory accident benefits for a chronic pain assessment.

The respondent insurer denied the benefit, arguing the applicant's ongoing impairments were related to pre-accident workplace injuries.

The Tribunal found that the accident materially contributed to the applicant's impairments and that the chronic pain assessment was reasonable and necessary to determine if the applicant suffered from chronic pain syndrome.

The Tribunal ordered the respondent to pay the $2,010.10 cost of the assessment plus interest.

The applicant sought a medical benefit of $6,103.09 for a physiotherapy treatment plan following a motor vehicle accident.

The respondent insurer denied the plan, arguing the applicant had reached maximum medical recovery and the treatment was not reasonable and necessary given her pre-existing chronic back pain and the length of time since the accident.

The adjudicator found that the applicant failed to prove the proposed treatment was reasonable and necessary, noting that after 3.5 years of similar treatment, there was no evidence showing how further facility-based treatment would achieve the stated goals.

The application was dismissed and no interest was payable.

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

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

The Licence Appeal Tribunal found that the applicant sustained a concussion and chronic pain, which are not minor injuries under the Schedule.

The Tribunal concluded the injuries fell outside the MIG and ordered the respondent to pay the $1,328.10 treatment plan, finding it reasonable and necessary, along with interest on overdue payments.

The applicant was injured in a rear-end motor vehicle accident and sought statutory accident benefits for a physiotherapy treatment plan.

The respondent insurer denied the treatment plan based on insurer's examinations that found no objective musculoskeletal pathology.

The Licence Appeal Tribunal found that the applicant's consistent subjective complaints of pain and his positive response to previous physiotherapy demonstrated that the treatment plan was reasonable and necessary.

The Tribunal ordered the respondent to pay the $2,992.60 treatment plan along with interest on overdue payments.

The applicant was struck by an SUV while riding a bicycle and subsequently developed severe psychological and emotional issues, including panic attacks and difficulty swallowing.

She sought $2,260 for a psychological assessment under the Statutory Accident Benefits Schedule.

The respondent insurer denied the claim, arguing it was unnecessary given her recent psychiatric treatment.

The Licence Appeal Tribunal found the assessment reasonable and necessary, noting the applicant's symptoms surfaced post-accident and persisted for years.

The Tribunal ordered the respondent to pay the cost of the assessment plus interest.

The applicant was injured in a motor vehicle accident and sought payment for a $2,200 chronic pain assessment.

The insurer denied the benefit, arguing the applicant's ongoing pain was related to her pre-existing Crohn's disease rather than the accident.

The Tribunal found the assessment was reasonable and necessary, noting the applicant had no history of such pain prior to the accident and had consistently sought treatment for over a year.

The Tribunal ordered the insurer to pay the cost of the assessment plus interest.

The applicant sought statutory accident benefits following a rear-end motor vehicle collision.

The insurer denied income replacement benefits beyond December 2016 and took the position that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant did not suffer a substantial inability to perform the essential tasks of her employment as a packager, noting her pre-existing conditions and lack of objective accident-related impairment.

The Tribunal also concluded that the applicant's injuries were predominantly minor and that her pre-existing degenerative disc disease and osteoarthritis did not prevent her from achieving maximal recovery within the $3,500 MIG limit.

The application was dismissed.

The applicant was injured in a motor vehicle accident and sought various medical, rehabilitation, and attendant care benefits from her insurer.

The insurer initially denied several treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG), but later conceded her injuries were outside the MIG following an insurer's examination.

The Tribunal found that the applicant was entitled to the disputed physiotherapy and chiropractic treatment plans, as well as the cost of an attendant care assessment, because her injuries, which included chronic pain syndrome, warranted treatment outside the MIG.

However, the Tribunal dismissed the applicant's claims for replacement eyeglasses and out-of-pocket physiotherapy and acupuncture expenses due to a lack of supporting evidence connecting them to the accident or complying with the requirement to submit a treatment plan.

The applicant's request for costs was also dismissed.

The applicant was injured in two motor vehicle accidents and sought ongoing income replacement benefits (IRBs) beyond the initial period paid by the insurer.

The insurer suspended and later denied further IRBs after the applicant initially failed to attend an Examination Under Oath (EUO).

The Tribunal found that the insurer did not act in bad faith in scheduling the EUO.

On the substantive issue, the Tribunal held that the applicant failed to prove on a balance of probabilities that he suffered a substantial inability to perform the essential tasks of his employment beyond the initial recovery period.

The application for ongoing IRBs, interest, costs, and a special award was dismissed.

The applicant, born prematurely two months after her mother was involved in a motor vehicle accident, sought attendant care benefits for Gastroesophageal Reflux Disease (GERD).

The applicant argued the accident caused the premature birth, which in turn caused the GERD.

The Tribunal found no evidence connecting the accident to the premature birth or the GERD condition.

The application for attendant care benefits, interest, a special award, and costs was dismissed.