Clive Forbes

The applicant sought a catastrophic impairment designation and attendant care benefits following a motor vehicle accident.

The Tribunal evaluated the competing multidisciplinary assessments to determine if the applicant met the 55% whole person impairment threshold under Criterion 7.

The Tribunal rejected several of the applicant's proposed impairment ratings, including those for the lumbar spine, headaches, mental status, and medication, finding them inconsistent with the AMA Guides and medical evidence.

The Tribunal concluded the applicant's combined whole person impairment was 45%, falling short of the catastrophic impairment threshold.

The application for benefits, interest, and costs was dismissed.

The applicant requested a reconsideration of a decision finding he was not involved in an 'accident' under s. 3(1) of the Statutory Accident Benefits Schedule.

The applicant argued the adjudicator breached procedural fairness and made errors of law and fact by failing to properly consider his evidence regarding a slip and fall at a Collision Reporting Centre following a guardrail collision.

The adjudicator dismissed the request, finding no breach of procedural fairness and that the applicant was improperly attempting to reweigh the evidence.

The original finding that the slip and fall was an intervening act, and not an accident, was upheld.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the respondent's determination that her injuries fell within the Minor Injury Guideline (MIG).

The applicant argued that accident-related psychological impairments and chronic pain warranted removal from the MIG, and claimed entitlement to a non-earner benefit (NEB) and various treatment plans.

The Tribunal found that the applicant failed to prove she suffered from a psychological impairment or chronic pain, noting that her family physician's records did not support her claims and she had returned to work post-accident.

The Tribunal concluded the applicant's injuries were predominantly minor, dismissed the claim for NEB as she did not suffer a complete inability to carry on a normal life, and denied the disputed treatment plans and interest.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied her claims for various statutory accident benefits, including attendant care, housekeeping, and medical treatments.

The applicant argued that the adjudicator committed a material breach of procedural fairness, demonstrated institutional bias, and made several errors of law and fact.

The Tribunal dismissed the request, finding no reasonable apprehension of bias or breach of procedural fairness.

The Tribunal also concluded that the adjudicator made no errors of law or fact, noting that the applicant was improperly attempting to use the reconsideration process to reweigh the evidence.

The applicant requested a reconsideration of a decision denying retroactive attendant care and housekeeping benefits, a chiropractic treatment plan, and interest.

The applicant alleged the adjudicator committed a material breach of procedural fairness, exhibited bias, and made errors of fact and law.

The Licence Appeal Tribunal dismissed the request, finding that the applicant failed to establish a reasonable apprehension of bias and was improperly attempting to use the reconsideration process to reweigh evidence and re-litigate the merits of the case.

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 TMJ disorders.

He also claimed income replacement benefits (IRB) and various treatment plans.

The Licence Appeal Tribunal found the applicant failed to prove his injuries fell outside the MIG, noting a lack of supporting medical evidence for chronic pain or psychological impairment.

The Tribunal also dismissed the IRB claim, finding the applicant's unemployment was due to the end of a seasonal contract rather than accident-related impairments.

The application was dismissed in its entirety.

The applicant sought statutory accident benefits following a motor vehicle accident, including an income replacement benefit.

The applicant failed to attend the scheduled videoconference hearing despite the Tribunal providing proper notice and making reasonable efforts to contact him.

As the applicant did not participate or present any evidence, he failed to meet his burden of proof to establish entitlement to the claimed benefits.

The application was dismissed.

The applicant was involved in a single-vehicle collision with a guardrail.

His vehicle was towed to a Collision Reporting Centre, where he slipped and fell on a snow-covered hill, fracturing his ankle.

He sought statutory accident benefits, claiming his injuries were caused by the collision.

The Tribunal found that the applicant was not involved in an 'accident' as defined by s. 3(1) of the Schedule, as the slip and fall was an intervening act that directly caused his injuries, breaking the causal link to the use or operation of the automobile.

The application for benefits was dismissed.

The applicant sought payment for various medical and rehabilitation benefits, including psychotherapy, chiropractic, acupuncture, massage, and occupational therapy expenses, following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application.

The Tribunal found the applicant was not entitled to the OCF-6 expenses because she failed to submit OCF-18 treatment plans prior to incurring the costs, as required by s. 38(2) of the Schedule.

The claim for chiropractic services was denied as the applicant failed to prove they were reasonable and necessary, with the Tribunal preferring the respondent's s. 44 assessment.

Finally, the claim for occupational therapy services related to provider travel time was dismissed because provider travel time is not an authorized transportation expense under s. 15(2)(c) of the Schedule.

The applicant sought payment for various medical and rehabilitation benefits, including psychotherapy, chiropractic, acupuncture, massage, and occupational therapy expenses, following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding that the applicant was not exempt from submitting treatment plans (OCF-18s) prior to incurring expenses claimed on OCF-6 forms.

The Tribunal also denied the claim for chiropractic services due to a lack of supporting medical evidence and denied the claim for occupational therapy provider travel time, as it is not an authorized transportation expense under the Schedule.

Claims for an award and interest were consequently dismissed.

The applicant sought various statutory accident benefits following a motor vehicle accident, including attendant care benefits, housekeeping and home maintenance, multiple treatment plans, medical cannabis, and botox injections.

The Licence Appeal Tribunal dismissed the application in its entirety.

The adjudicator found that the applicant's claims for attendant care and housekeeping were inconsistent with her pre- and post-accident level of function, noting she continued to work full-time and her family performed most household chores.

The requested treatment plans and medical expenses were deemed not reasonable and necessary, as they were unsupported by the contemporaneous medical evidence and the applicant failed to provide adequate information to the insurer.

Claims for an award and interest were also dismissed as no benefits were overdue.

The applicant sought retroactive attendant care benefits (ACBs), housekeeping and home maintenance benefits (HKHM), chiropractic services, and occupational therapy services following a 1997 motor vehicle accident that resulted in a catastrophic impairment.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to prove that the delay in submitting a retroactive Form 1 was due to urgency, impossibility, or impracticability, as required by the Morrissey decision.

The Tribunal also found no evidence that the ACB or HKHM expenses were actually incurred.

Furthermore, the requested chiropractic treatment and a one-year golf membership were deemed not reasonable and necessary based on the medical evidence.

Claims for a section 10 award, interest, and costs were also dismissed.

The applicant requested a reconsideration of a decision denying her entitlement to post-104-week income replacement benefits (IRB) and interest.

The applicant argued that the adjudicator erred in law and fact by failing to properly analyze the post-104-week IRB test, misapprehending evidence, providing inadequate reasons, and demonstrating bias against subjective pain complaints.

The Tribunal dismissed the request, finding no violation of procedural fairness or significant error of law or fact that would have altered the original decision.

The adjudicator held that the original decision properly considered both objective and subjective evidence and correctly applied the post-104-week IRB test.

The applicant requested a reconsideration of a decision finding she was not catastrophically impaired under Criterion 8 of the Schedule.

The applicant argued the adjudicator erred in law and fact by misapplying the Schedule, rejecting expert psychiatric opinions, misapplying the causation test, and ignoring evidence of deterioration.

The Tribunal dismissed the request, finding no errors of law or fact that would have changed the outcome.

The adjudicator noted that assigning weight to evidence and preferring certain evidence over expert opinions falls within the adjudicator's role and does not constitute an error of law.

The applicant sought a catastrophic impairment (CAT) designation following a 2011 motor vehicle accident.

The applicant claimed a marked impairment in multiple domains due to mental and behavioural disorders.

The Tribunal found that the applicant's impairments largely pre-dated the accident, stemming from a 2007 workplace injury and subsequent incidents.

The Tribunal concluded that the accident only mildly exacerbated the pre-existing conditions and did not significantly impede useful functioning.

The application for CAT designation was dismissed.

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

The Licence Appeal Tribunal found insufficient evidence of functional impairment from chronic pain and preferred the respondent's psychological assessment over the applicant's, concluding she did not suffer a psychological impairment.

The application was dismissed, and the disputed treatment plans and interest were denied.

The applicant requested a reconsideration of a decision finding she was not catastrophically impaired.

She argued the adjudicator failed to apply the correct causation test regarding her pre-existing disability and cherry-picked evidence.

The Tribunal dismissed the request, finding no violation of procedural fairness or significant error of law or fact.

The adjudicator held that the original decision properly considered the applicant's pre- and post-accident functional abilities and that assigning weight to evidence is an intrinsic function of the Tribunal, not an error.

The applicant requested a reconsideration of a Tribunal decision that denied her entitlement to post-104 week income replacement benefits (IRBs).

The applicant argued the Tribunal made errors of law and fact, including misapprehending the medical reasons for the IRB stoppage, failing to consider both physical and psychological impairments, and failing to quantify her entitlement.

The Tribunal dismissed the request, finding no errors of law, fact, or procedural fairness that would have changed the outcome.

The Tribunal also rejected the applicant's attempt to introduce a recent Court of Appeal decision as new evidence, noting that case law does not constitute evidence under the reconsideration rules.

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

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

The applicant argued for removal from the MIG due to chronic pain and psychological impairments.

The Tribunal found insufficient evidence of functional impairment from chronic pain or a psychological impairment caused by the accident.

As the MIG limits were exhausted, the treatment plans were not payable and the application was dismissed.

The applicant sought a determination that she sustained a catastrophic impairment (CAT) under Criterion 8 of the Statutory Accident Benefits Schedule following a motor vehicle accident.

The respondent argued the application was barred by res judicata and abuse of process due to a prior Tribunal decision denying post-104-week income replacement benefits.

The Tribunal rejected the preliminary objections, finding the applicant relied on new medical evidence.

On the merits, the Tribunal found the applicant's impairments, including her psychological and chronic pain conditions, largely pre-dated the accident.

The Tribunal rejected the applicant's expert evidence as flawed and concluded she did not suffer a marked impairment in three of four domains of function.

The application was dismissed.