Jeff Chatterton

The applicant sought accident benefits following a motor vehicle accident but was denied by the respondent on the basis that his injuries fell within the Minor Injury Guideline (MIG).

The applicant argued he should be removed from the MIG due to chronic pain.

The Tribunal found that the applicant's clinical notes did not establish ongoing, consistent complaints of accident-related pain, and a section 44 assessment concluded he suffered only minor sprain and strain injuries.

The Tribunal held the applicant to the MIG limit and dismissed the claims for further treatment plans and interest.

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

The insurer denied benefits and scheduled insurer's examinations under s. 44 of the Schedule.

The applicant refused to attend the examinations, arguing it was improper to schedule them after the Tribunal application had been filed.

The Tribunal found that the insurer had properly scheduled the examinations and that the applicant failed to provide a reasonable explanation for her non-attendance.

Consequently, pursuant to s. 55(1)2 of the Schedule, the applicant was barred from proceeding to a hearing, and the application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically $2,200 for a psychological assessment, along with interest and an award for unreasonable delay.

The Tribunal scheduled a written hearing, but the applicant failed to file any submissions or evidence.

Pursuant to section 7(2) of the Statutory Powers Procedure Act, the Tribunal proceeded with the hearing in the applicant's absence.

As the applicant failed to meet her evidentiary burden, the application was dismissed in its entirety.

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

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

The Tribunal found that the applicant suffered a psychological injury, specifically severe anxiety and depression, warranting removal from the MIG.

The Tribunal preferred the evidence of the applicant's psychologist over the respondent's expert, whose report was found to be internally inconsistent.

The applicant was awarded $2,200.00 for a psychological assessment and interest on overdue benefits, but the claim for a special award was dismissed.

The applicant sought entitlement to statutory accident benefits for chiropractic and psychological services following a motor vehicle accident.

The adjudicator found that the applicant failed to establish that the chiropractic treatment plans were reasonable and necessary, noting a lack of supportive medical referrals and failure to link a knee injury to the accident.

The adjudicator also denied the disputed amounts for psychological services, finding no evidence to support the necessity of the specific administrative items claimed.

The application was dismissed.

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

The respondent denied a proposed psychological assessment on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant failed to provide medical evidence to establish that his injuries fell outside the MIG.

The Tribunal also rejected the applicant's procedural argument that the respondent's denial letter violated section 38(8) of the Schedule, finding the letter provided a sufficient medical reason by referencing the MIG.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, arguing for removal from the Minor Injury Guideline (MIG) on the basis of chronic pain.

The Licence Appeal Tribunal found that the applicant failed to provide objective medical evidence of a functional impairment accompanying the chronic pain.

Relying on the respondent's section 44 multidisciplinary assessments, which concluded the applicant had reached maximum medical recovery, the Tribunal held the applicant to the MIG.

Consequently, the disputed treatment plans were not assessed for reasonableness and necessity, and claims for interest and a section 10 award were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to removal from the Minor Injury Guideline (MIG) due to psychological injuries (driving anxiety) and physical injuries (chronic pain).

The Tribunal found that the applicant failed to meet his burden of proof for removal from the MIG.

The Tribunal preferred the respondent's psychological assessment, which found no psychological injury, over the applicant's assessment, noting methodological weaknesses in the latter.

Furthermore, the applicant provided insufficient evidence of chronic pain with functional impairment.

As the applicant remained subject to the $3,500 MIG limit, the disputed treatment plans and claims for interest were dismissed.

The applicant, who was catastrophically impaired following a motor vehicle accident, sought entitlement to various statutory accident benefits including home modifications, assistive devices, and medications.

The Licence Appeal Tribunal dismissed the application in its entirety.

The claim for home modifications was denied under s. 38(2) of the Schedule because the expenses were incurred before the treatment plan was submitted.

The claims for a bathmat, blender, and various supplements were dismissed as the applicant failed to establish they were reasonable and necessary or causally related to the accident.

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

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 for removal from the MIG based on psychological injury and chronic pain.

The Tribunal preferred the respondent's psychological assessment over the applicant's, noting the respondent's assessor was a psychologist rather than a psychological associate, and the applicant's assessment was from the same clinic proposing the treatment.

The Tribunal also found insufficient evidence of accident-related chronic pain with functional impairment.

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

The applicant sought Non-Earner Benefits following a motor vehicle accident.

The respondent insurer argued the claim was barred by the two-year limitation period.

The Tribunal found the limitation period was never triggered because the insurer failed to issue a proper denial notice after receiving the applicant's OCF-3 disability certificate.

Due to the insurer's failure to comply with section 36(4) of the Statutory Accident Benefits Schedule, it was automatically liable to pay the benefits under section 36(6).

The Tribunal ordered the insurer to pay $19,240.00 in Non-Earner Benefits plus interest, but declined to grant an award under section 10 of Regulation 664, finding the insurer's mistake did not amount to unreasonable conduct.

The applicant sought statutory accident benefits following a motor vehicle accident, including psychological services, physiotherapy, and assessments for chronic pain and orthopedic issues.

The respondent denied the benefits.

The Tribunal found that the applicant failed to prove the treatments and assessments were reasonable and necessary.

Specifically, the Tribunal ruled that a psychotherapist is not entitled to the same hourly rate as a psychologist under the Professional Services Guideline absent evidence of equivalent services or close supervision.

The Tribunal also accepted the respondent's independent medical examination report, which concluded the applicant had reached maximal medical recovery.

The application was dismissed, and claims for interest and an award were denied.

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

The respondent partially denied several treatment plans, arguing that psychotherapists are not entitled to the higher hourly rate of psychologists under the Professional Services Guideline.

The Tribunal found that the applicant failed to establish that the higher rate was reasonable and necessary.

However, the Tribunal found that one of the respondent's denial letters violated s. 38(8) of the Schedule by failing to provide reasons for the partial denial, entitling the applicant to $637.07 for that plan.

The remaining claims were dismissed, including two that were barred by the two-year limitation period.

The applicant sought entitlement to two treatment plans for psychological services, an award, and interest following a motor vehicle accident involving her father.

The Licence Appeal Tribunal denied the application, finding that the applicant failed to prove the treatments were reasonable and necessary.

The Tribunal preferred the respondent's psychological assessment, which found the applicant failed validity testing and exhibited symptom magnification, over the applicant's outdated progress reports that lacked objective testing data.

As no benefits were payable, the claims for interest and an award were also dismissed.

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

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

The applicant argued the respondent's denial letters were non-compliant with s. 38(8) of the Schedule.

The Tribunal found the applicant failed to provide compelling medical evidence to warrant removal from the MIG.

Furthermore, the Tribunal held that the respondent's denial letters were compliant with the Schedule, as they clearly stated the lack of objective medical evidence as the reason for denial.

The application was dismissed.

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

The respondent denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant failed to provide sufficient medical evidence to prove his injuries extended beyond sprains and strains or that he suffered from chronic pain with a functional limitation.

Consequently, the applicant remained subject to the MIG and was not entitled to the disputed treatment plans, interest, or an award.

The applicant sought statutory accident benefits following a motor vehicle accident but was denied by the respondent insurer.

The applicant applied to the Licence Appeal Tribunal to dispute the denial of several treatment plans for physiotherapy and assessments, arguing the denial letters were non-compliant with s. 38(8) of the Schedule.

The Tribunal found that the applicant failed to meet the burden of proving her injuries warranted removal from the Minor Injury Guideline (MIG).

Furthermore, the Tribunal held that the respondent's denial letters were compliant with the Schedule, as they clearly identified the treatment plans, stated what would not be paid for, and provided the medical reason that the injuries fell within the MIG.

The application was dismissed.

The applicant sought $2,460 for a Chronic Pain Assessment following a motor vehicle accident, which the respondent insurer denied based on a s. 44 insurer's examination.

The Tribunal found the assessment reasonable and necessary, noting that the applicant's treating practitioners consistently documented chronic pain and even the respondent's assessor acknowledged the applicant's considerable discomfort.

The Tribunal also granted an award of 25% under s. 10 of Regulation 664, finding the respondent's denial stubborn and inflexible given the overwhelming medical evidence of chronic pain.

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 she should be removed from the MIG due to a concussion and pre-existing scoliosis.

The Tribunal found insufficient medical evidence to support an accident-related concussion, preferring the respondent's neurological assessment.

The Tribunal also found no compelling medical evidence that the applicant's pre-existing scoliosis would preclude her recovery within the MIG.

The application was dismissed.

The applicant sought entitlement to statutory accident benefits following a 2019 motor vehicle accident, disputing the insurer's denial of various treatment and assessment plans.

The Licence Appeal Tribunal found that the applicant failed to prove that psychiatric, psychological, orthopaedic, and functional abilities assessments were reasonable and necessary.

However, the Tribunal partially approved a physiotherapy treatment plan, noting that pain reduction is a legitimate goal, while excluding the cost of orthotic devices unrelated to the accident.

The applicant's request for an award under s. 10 of O. Reg. 664 was denied, as the insurer's conduct was not found to be unreasonable.