Henry Harris

The applicant sought statutory accident benefits following a motor vehicle accident, including a determination of catastrophic impairment under Criterion 8 (mental and behavioural disorders), income replacement benefits, attendant care benefits, and various treatment plans.

The Tribunal found that the applicant did not meet the catastrophic impairment threshold, as she failed to establish a marked impairment in the sphere of social functioning, noting her ongoing close familial relationships and 18-month post-accident employment at a school.

The Tribunal also dismissed the claims for income replacement benefits, finding the respondent's medical experts persuasive that she did not suffer a substantial inability to perform her pre-accident employment tasks.

The claims for attendant care benefits and treatment plans were dismissed due to a lack of evidence demonstrating the expenses were incurred or reasonable and necessary.

The applicant sought statutory accident benefits following a 2015 motor vehicle accident, claiming catastrophic impairment due to mental and behavioural disorders and entitlement to income replacement benefits (IRB).

The Licence Appeal Tribunal found that the applicant did not meet the threshold for catastrophic impairment under Criterion 8, as he sustained only moderate, rather than marked, impairments in activities of daily living and adaptation.

The Tribunal preferred the respondent's psychiatric assessment, noting the applicant maintained useful functioning such as driving, going to the gym, and caring for his parents.

The Tribunal also dismissed the claim for IRB, finding insufficient objective medical evidence that the applicant suffered a substantial inability to perform the essential tasks of his pre-accident employment as an IT technician.

Claims for an award and interest were consequently dismissed.

The applicant sought statutory accident benefits following a 2022 motor vehicle accident.

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

The applicant argued that pre-existing chronic pain and psychological impairments from a 2009 accident warranted removal from the MIG.

The Tribunal found the applicant failed to provide compelling medical evidence that her pre-existing conditions prevented maximal recovery within the MIG limit, preferring the respondent's psychiatric assessment over the applicant's psychological report.

The Tribunal also dismissed the applicant's claim for a non-earner benefit due to the failure to submit a completed disability certificate within the 104-week entitlement period.

The application was dismissed in its entirety.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming catastrophic impairment under Criteria 6 and 7 of the Schedule.

The Tribunal found the applicant did not meet the 55% whole person impairment threshold, preferring the respondent's medical experts who assessed a 25% combined impairment over the applicant's experts whose ratings were unsupported by the AMA Guides.

The Tribunal also dismissed claims for income replacement benefits, attendant care benefits, and various treatment plans due to a lack of supporting evidence.

The respondent's claim for repayment of income replacement benefits was also dismissed for lack of evidence.

The applicant sought statutory accident benefits following a motor vehicle accident but failed to attend the scheduled videoconference hearing.

The Tribunal proceeded in his absence pursuant to section 7(3) of the Statutory Powers Procedure Act.

Because the applicant presented no evidence or submissions, he failed to meet his burden of proof, and the application was dismissed.

The Tribunal also denied the respondent's request for costs, finding that the applicant's mere failure to attend did not constitute unreasonable or vexatious conduct that interfered with the Tribunal's process.

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

The Tribunal found that the applicant failed to prove on a balance of probabilities that he suffered an accident-related psychological impairment, preferring the evidence of the respondent's psychiatric assessor and the applicant's treating psychiatrist over the applicant's psychological assessor.

The Tribunal also found that the respondent's denial of a treatment plan was timely and compliant with the notice requirements under s. 38(8) of the Schedule.

The application was dismissed, and the applicant was held to the MIG limits.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits from the respondent insurer.

The Licence Appeal Tribunal considered whether the applicant was entitled to pre-104 week and post-104 week income replacement benefits (IRBs), various treatment plans, interest, and a special award.

The Tribunal found that the applicant, a self-employed massage therapist, suffered a substantial inability to perform the essential tasks of her employment and was entitled to pre-104 week IRBs.

However, the Tribunal rejected the applicant's claim that her self-employment income was $30,000, finding the supporting documentation unreliable, and instead calculated the IRBs at $169.00 per week based on her originally declared income.

The applicant failed to establish entitlement to post-104 week IRBs.

The Tribunal approved several treatment plans, including occupational therapy, rehabilitation support worker sessions, psychotherapy, an attendant care assessment, and a rollator walker, finding them reasonable and necessary based on the medical evidence, including supportive reports from the respondent's own occupational therapy assessor.

Other treatment plans were denied for lack of evidence.

The Tribunal awarded interest on overdue payments but denied the request for a special award, concluding the insurer's reliance on its own medical reports was not unreasonable.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically funding for psychological assessments, psychological counselling, and chiropractic treatment.

The respondent insurer denied the treatment plans.

The applicant argued that the insurer failed to comply with the notice requirements under s. 38(8) of the Statutory Accident Benefits Schedule, which would trigger an obligation to pay.

The Tribunal found that the insurer's explanation of benefits letters provided sufficient medical and other reasons for the denials, including the absence of updated medical records and reliance on prior insurer's examinations.

As the insurer complied with s. 38(8), the applicant was not entitled to the disputed treatment plans, interest, or an award for unreasonable delay.

The applicant sought statutory accident benefits following a 2017 motor vehicle accident.

The respondent denied treatment plans for a neuro-optometric assessment, prolotherapy, and psychological services.

The Tribunal found the neuro-optometric assessment was not reasonable and necessary, as the supporting medical reports were either not contemporaneous or did not recommend further assessments.

The Tribunal approved the prolotherapy plan, preferring the in-person assessment of the applicant's physiatrist over the respondent's remote assessment.

The claim for the balance of psychological services was dismissed, as the applicant failed to justify the need for an updated assessment or the higher hourly rate for a psychotherapist.

The applicant sought entitlement to statutory accident benefits for a neurological assessment and two physiotherapy treatment plans following a motor vehicle accident.

The Tribunal found the neurological assessment reasonable and necessary, as contemporaneous medical records from the treating neurologist supported the need for further investigation of post-concussive syndrome.

However, the Tribunal denied the physiotherapy plans, relying on an insurer's examination report which concluded that further physical treatment would not be beneficial given the applicant's lack of response to a year of prior therapy.

Interest was awarded on the overdue payment for the neurological assessment.