Jeff Chatterton

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

The matter was scheduled for a written hearing, but neither party filed submissions.

The applicant's counsel had emailed the Tribunal requesting an adjournment due to a medical emergency but failed to file a formal motion or subsequent submissions.

Pursuant to section 7(2) of the Statutory Powers Procedure Act, the Tribunal proceeded without the applicant's participation.

As the applicant bore the onus of proof and provided no evidence, the application for treatment plans, an award, and interest was dismissed.

The applicant sought entitlement to statutory accident benefits following a motor vehicle accident, specifically claiming costs for psychiatric, orthopaedic, functional abilities, and psychological assessments, as well as a physiotherapy treatment plan.

The Tribunal dismissed the claims for the assessments, finding the applicant failed to demonstrate they were reasonable and necessary, noting she had already been diagnosed and was receiving treatments.

The Tribunal partially granted the physiotherapy treatment plan, approving it for pain reduction but excluding the cost of orthotic devices unrelated to the accident.

The claim for a special award under s. 10 of Reg. 664 was dismissed, as the insurer's conduct was not found to be unreasonable.

Interest was awarded on the overdue physiotherapy benefits.

The applicant sought a non-earner benefit following a motor vehicle accident.

The applicant argued that the insurer failed to provide a compliant notice under section 36(4) of the Schedule, and therefore the benefit was payable under section 36(6).

The Tribunal found that the insurer's denial letter was issued under section 36(7) following an insurer's examination, and the Schedule provides no remedy for non-compliance with section 36(7).

The Tribunal further found that the applicant failed to meet the substantive test for a non-earner benefit, as no evidence was provided to compare pre- and post-accident activities.

The application was dismissed, and the respondent's request for costs was denied.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming entitlement to chiropractic treatments, an in-home assessment, and in-home treatments.

The Licence Appeal Tribunal dismissed the application, finding that the applicant had achieved maximal recovery and functional range of motion.

The Tribunal preferred the respondent's insurer's examinations, noting the applicant had returned to full-time employment as a nurse and was able to participate in activities such as hiking, cycling, and yoga.

As no benefits were payable, the claim for interest was also 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 for removal from the MIG on the basis of chronic pain with functional impairment.

The Tribunal found the applicant failed to provide sufficient objective medical evidence to establish chronic pain with a functional limitation, noting the applicant's own expert did not diagnose chronic pain.

As the applicant was held to the MIG and the disputed treatment plans exceeded the remaining limits, the application was dismissed.

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 applicant sought removal from the MIG based on chronic pain and psychological injury, specifically PTSD.

The Tribunal found that the applicant failed to establish chronic pain with a functional impairment, noting she had returned to her daily activities, including driving.

The Tribunal also preferred the respondent's psychological assessment, finding the applicant's psychological symptoms were clinically associated sequelae of her minor soft tissue injuries.

The application was dismissed.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for two physiotherapy treatment plans.

The Tribunal found the December 2023 treatment plan for $1,828.10 was reasonable and necessary based on the recommendations of the applicant's family physician and an orthopaedic surgeon.

However, the Tribunal denied the remaining $117.07 from a July 2023 treatment plan because neither party provided submissions regarding the disputed amount.

The application was granted in part, with interest payable on overdue benefits.

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

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

Relying on an insurer's examination report which concluded the injuries were minor and maximal recovery was achieved, the Tribunal held the applicant to the MIG.

Consequently, the claims for additional treatment plans, an award for unreasonable delay, and interest were 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.

The matter proceeded to a written hearing.

The applicant failed to file any submissions or evidence despite receiving notice.

Consequently, the Tribunal proceeded without her participation under section 7(2) of the Statutory Powers Procedure Act.

As the applicant bore the onus of proof and provided no evidence, the Tribunal found she failed to demonstrate entitlement to removal from the Minor Injury Guideline or to the disputed treatment plans.

The application was dismissed.

The applicant sought a non-earner benefit, medical benefits for chiropractic and psychological services, and an award under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The Tribunal dismissed the application in its entirety.

Surveillance evidence and employment records demonstrated that the applicant had returned to full-time, physically demanding work as a personal support worker during the period he claimed a complete inability to carry on a normal life.

The requested treatment plans were found not to be reasonable and necessary, and no benefits were unreasonably withheld or delayed.

The applicant sought statutory accident benefits following a 2014 motor vehicle accident.

The Licence Appeal Tribunal found the applicant was entitled to $1,748.81 for assistive devices and physical therapy, as the occupational therapy assessment supported their necessity for a return to normal life.

However, the Tribunal denied a $3,081.50 chronic pain assessment due to a lack of contemporaneous medical evidence and the applicant's failure to attend a previously approved assessment.

Claims for an award under s. 10 of Regulation 664 were dismissed, but interest was awarded on the overdue benefits.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming he should be removed from the Minor Injury Guideline (MIG) due to a concussion and psychological injuries.

The Licence Appeal Tribunal found that the applicant failed to meet his burden of proof, as the contemporaneous medical evidence primarily indicated musculo-skeletal injuries and did not support the claimed concussion or psychological impairments.

The Tribunal gave little weight to the applicant's expert reports because they were authored nearly three years after the accident.

Consequently, the applicant remained subject to the MIG limit, and his claims for various treatment plans, interest, and an award were dismissed.

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

The respondent insurer partially approved the treatment plan for the applicant's shoulder but denied coverage for the knee, relying on an independent medical examination that attributed the knee pain to pre-existing osteoarthritis.

The adjudicator found the unapproved physiotherapy reasonable and necessary, noting that the respondent's own medical expert acknowledged the applicant's knee pain worsened when treatment stopped.

The claim for the unapproved amount and interest was granted, but the request for an award for unreasonable delay was dismissed as the insurer had acted in good faith.

The applicant sought statutory accident benefits following a motor vehicle accident, arguing for removal from the Minor Injury Guideline (MIG) due to chronic pain and psychological injury.

The Licence Appeal Tribunal found the applicant failed to meet the burden of proof, noting a lack of objective medical evidence and that the psychological report was authored without reviewing medical records.

The application was dismissed, and the applicant remained subject to the $3,500 MIG limit, rendering the disputed $13,306.63 chiropractic treatment plan moot.

The applicant sought $6,004.20 for a treatment plan following a 2015 motor vehicle accident.

The respondent denied the plan, citing a lack of medical evidence over the intervening seven years and referencing the Minor Injury Guideline.

The applicant argued the denial was non-compliant because it relied on the MIG.

The Tribunal found the denial compliant, as the primary reason was the valid medical reason of scarce evidence.

The Tribunal dismissed the application, finding the applicant failed to provide sufficient medical evidence to prove the proposed treatment was reasonable and necessary.

The applicant sought non-earner benefits (NEBs) following a motor vehicle accident, arguing the insurer failed to properly deny the NEB claim after initially paying income replacement benefits (IRBs).

The Tribunal held that the acceptance and payment of IRBs implied a denial of NEBs, as the two benefits are mutually exclusive under the current Schedule.

Furthermore, the applicant failed to meet the substantive test for NEBs, as evidence demonstrated she had returned to work, drove her own vehicle, and performed housekeeping tasks, meaning she did not suffer a complete inability to carry on a normal life.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming the psychologist hourly rate ($149.62) for psychological treatment plans.

The respondent insurer approved the plans but only at a rate of $99.75 per hour, arguing the services were provided by a qualifying psychotherapist, not a psychologist.

The Tribunal found that the applicant failed to prove the psychotherapist was performing work essentially similar to a psychologist or was qualified to provide cognitive behavioural therapy.

The application was dismissed, and the respondent's approved rate was deemed reasonable.

The applicant sought payment for psychological services at the psychologist rate of $149.62 per hour, while the respondent approved the services at a rate of $99.75 per hour, arguing the provider was a qualifying psychotherapist.

The Tribunal found that the applicant failed to provide evidence demonstrating that the work performed by the qualifying psychotherapist was essentially the same as that of a psychologist or that the provider was qualified to provide cognitive behavioural therapy.

The application for the disputed amounts and interest was dismissed.

The applicant sought non-earner benefits and a treatment plan for physiotherapy following a motor vehicle accident.

The insurer denied the claims.

The Tribunal found that the insurer's initial denial letter was compliant with the Statutory Accident Benefits Schedule as it provided a valid non-medical reason.

However, the insurer failed to issue a proper denial after the applicant eventually complied with a section 33 request for information.

As a result, the Tribunal ordered the insurer to pay 15 weeks of non-earner benefits, excluding the period of the applicant's non-compliance.

The claim for the physiotherapy treatment plan was dismissed because a valid denial was issued and no treatments were incurred during the one-day delay in providing the notice.

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

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

The applicant argued for removal from the MIG based on chronic pain and psychological injuries.

The Tribunal found the applicant failed to prove chronic pain with a functional limitation.

Regarding psychological injuries, the Tribunal preferred the respondent's expert evidence, which relied on objective testing, over the applicant's expert, who used primarily subjective self-reporting tools.

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