Gordon Stencell

The applicant, a pedestrian struck by a motor vehicle, sought accident benefits beyond the $3,500 Minor Injury Guideline (MIG) limit, claiming removal was warranted due to a pre-existing condition, psychological impairment, and chronic pain.

The Licence Appeal Tribunal found insufficient evidence that her pre-existing mechanical back pain prevented recovery within the MIG.

The Tribunal preferred the respondent's psychological assessment over the applicant's, finding no psychological impairment or chronic pain resulting from the accident.

As the applicant remained within the MIG, the disputed treatment plans were denied, and claims for a special award and interest were dismissed.

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

The Tribunal found that the Applicant's injuries were predominantly minor and subject to the $3,500 Minor Injury Guideline (MIG) limit, as he failed to establish chronic pain with functional impairment or a psychological impairment warranting removal.

Although subject to the MIG, the Tribunal ordered the Respondent to pay for a $4,959.75 psychological treatment plan because the Respondent failed to comply with the notice requirements under s. 38(8) of the Schedule.

Claims for other treatment plans and a special award were dismissed.

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

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

The Tribunal found that the applicant's physical injuries, including a partial shoulder tear, were minor injuries by definition.

The Tribunal also found insufficient evidence that a pre-existing condition would prevent maximal recovery within the MIG limits.

As the applicant remained within the MIG, the disputed treatment plans were not considered, and no interest was awarded.

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

The applicant argued for removal from the MIG based on a pre-existing degenerative disc disease and chronic pain.

The Licence Appeal Tribunal found that the applicant failed to provide compelling medical evidence that his pre-existing condition prevented maximal recovery within the MIG.

Furthermore, applying the AMA Guides, the Tribunal concluded the applicant did not meet the criteria for chronic pain with functional impairment, noting he continued to work and exercise.

The application was dismissed, and the disputed treatment plan was not considered as the applicant remained subject to the MIG limit.

The applicant sought statutory accident benefits following a motor vehicle accident, arguing his injuries warranted removal from the Minor Injury Guideline (MIG) due to persistent back pain and headaches.

The respondent denied the benefits, relying on medical records showing pre-existing back pain and a prior stroke as the cause of the headaches.

The Tribunal found the applicant failed to prove his injuries fell outside the MIG.

Consequently, the disputed treatment plan for chiropractic services was not payable, and claims for an award and interest were dismissed.

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

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

The applicant argued that psychological impairment and chronic pain warranted removal from the MIG.

The adjudicator found that the applicant failed to discharge his burden of proof, noting inconsistencies in the psychological report and a lack of contemporaneous medical evidence supporting chronic pain or functional limitations.

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

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

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

The applicant argued she should be removed from the MIG due to chronic pain, relying on clinical notes from a rheumatologist.

The Tribunal found the clinical notes were from more than two years post-accident and contained no records of chronic pain caused by the accident.

The Tribunal concluded the applicant failed to prove she suffered from chronic pain with functional impairment as a result of the accident, and therefore her injuries were subject to the MIG limit.

The application for various treatment plans was dismissed.

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

The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and that she failed to properly elect an income replacement benefit (IRB) before commencing the application.

The Licence Appeal Tribunal found that the applicant's injuries were predominantly minor, as she failed to provide sufficient medical evidence of a psychological impairment or chronic pain with functional impairment to warrant removal from the MIG.

Consequently, the disputed treatment plans were not payable.

Furthermore, the Tribunal held that the applicant was not entitled to an IRB because she failed to submit an OCF-10 election form prior to filing the application, a defect that could not be cured retroactively.

The application was dismissed.

The applicant was severely injured in a motor vehicle accident and submitted his application for accident benefits (OCF-1) nearly a year late.

The respondent denied benefits on the basis of the delay.

The Tribunal found the applicant had a reasonable explanation for the delay due to his severe brain and physical injuries, and the respondent's failure to adequately communicate the consequences of not filing or to accommodate his disabilities.

The Tribunal ordered the respondent to pay the disputed physiotherapy treatment plan, interest, and a maximum 50% special award under s. 10 of Reg. 664 for unreasonably delaying and withholding benefits.

The applicant, who sustained a catastrophic impairment in a 2009 motor vehicle accident, sought various medical, rehabilitation, and visitor expenses from the respondent insurer.

The Licence Appeal Tribunal denied the claims for prescription expenses, advanced service dog training, an office chair, air brush supplies, a service dog licence, and a replacement iPhone, finding the applicant failed to prove they were reasonable and necessary.

However, the Tribunal granted the claims for sibling visitor expenses, finding them reasonable and necessary to prevent the applicant's isolation due to his impairments.

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

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

The applicant argued for removal from the MIG based on psychological impairment.

The Tribunal found that the applicant did not demonstrate a psychological condition warranting removal from the MIG, noting a lack of psychological complaints until a year after the accident and relying on an insurer's examination report.

As the applicant remained in the MIG, the disputed treatment plans were not payable.

Claims for an award and interest were also dismissed.