Laura Goulet

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 Tribunal found the applicant failed to provide sufficient medical evidence to prove a psychological impairment that would warrant removal from the MIG.

The Tribunal also dismissed the claim for non-earner benefits, as the applicant did not demonstrate a complete inability to carry on a normal life.

Claims for a psychological assessment, an award, and interest were also dismissed.

The applicant was injured in a motor vehicle accident and sought various treatment plans under the Statutory Accident Benefits Schedule.

The respondent denied the plans.

The Tribunal found that the applicant was not entitled to the treatment plans for chiropractic services, an orthopedic assessment, and chronic pain treatment, as he failed to demonstrate they were reasonable and necessary.

However, the Tribunal found the applicant was entitled to a chronic pain assessment to investigate his ongoing pain complaints, along with interest on overdue benefits.

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 Tribunal found the applicant sustained a concussion, warranting removal from the MIG.

The Tribunal approved one treatment plan for physiotherapy services supported by contemporaneous medical evidence but denied two subsequent plans due to a lack of medical recommendations.

The applicant was awarded interest on overdue payments, but the claim for a special award under s. 10 of Regulation 664 was dismissed as the insurer's conduct was not unreasonable.

The applicant sought various medical and rehabilitation 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 issue of the applicant's MIG status had already been decided in a previous hearing, and therefore the doctrine of issue estoppel applied.

The Tribunal rejected the applicant's argument that new medical reports constituted fresh evidence or that fairness required waiving issue estoppel, as the reports did not establish that her pre-existing osteoarthritis would prevent maximal recovery under the MIG.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to various treatment plans for physical and psychological impairments.

The respondent denied the plans, arguing a lack of corroborating medical evidence and that certain costs, such as PPE, were administrative overhead.

The Tribunal found that the applicant failed to meet the burden of proving the treatment plans were reasonable and necessary, noting the absence of contemporaneous clinical notes from a family physician.

The Tribunal also held that PPE costs are captured by administrative overhead under the Professional Services Guideline.

The application was dismissed in its entirety.

The applicant sought accident benefits following a motor vehicle accident, claiming her injuries fell outside the Minor Injury Guideline (MIG) due to a concussion, psychological impairment, and Chronic Pain Syndrome.

The Tribunal found insufficient medical evidence to support a diagnosis of a concussion or a psychological impairment, noting the applicant's pre-existing anxiety and lack of objective testing.

The Tribunal also rejected the chronic pain claim, finding the applicant did not meet the criteria under the AMA Guides and lacked evidence of functional impairment.

As the injuries were deemed predominantly minor, the application for disputed treatment plans beyond the MIG limit was dismissed.

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

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

The Tribunal found that the applicant's physical injuries were soft tissue in nature and that she failed to establish a psychological impairment that would remove her from the MIG.

Because the MIG limit was exhausted and the respondent's denial notices complied with the Schedule, the applicant was not entitled to the disputed treatment plans.

The applicant sought statutory accident benefits for a multidisciplinary chronic pain treatment program and chiropractic services following a motor vehicle accident.

The insurer denied the benefits.

The Licence Appeal Tribunal found that the applicant failed to prove on a balance of probabilities that he suffered from chronic pain syndrome or that the proposed treatment plans were reasonable and necessary.

The Tribunal noted a lack of objective medical evidence and found that the applicant did not meet the criteria for chronic pain under the AMA Guides.

The application was dismissed.

The applicant was injured 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 Tribunal found that the applicant sustained a concussion, which removed him from the MIG.

However, the Tribunal dismissed the applicant's claims for various chiropractic treatment plans and a psychological assessment, finding that the applicant failed to prove they were reasonable and necessary.

No interest was payable.

The applicant sought a determination that she sustained a catastrophic impairment due to psychological injuries following a motor vehicle accident, along with payment for assessment costs.

The Tribunal found the applicant to be an unreliable historian, noting significant inconsistencies between her testimony and her pre-accident psychiatric records which documented pre-existing depression, poor memory, and suicidal thoughts.

The Tribunal placed little weight on the applicant's expert reports because they relied on her incomplete self-reporting.

The application was dismissed as the applicant failed to prove she suffered marked impairments in three domains of functioning as a result of the accident.

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

A 10-day videoconference hearing was scheduled, but the applicant failed to attend and did not provide any documentary evidence.

The Tribunal proceeded in the applicant's absence pursuant to Rule 3.7.1 of the Licence Appeal Tribunal Rules.

As the applicant failed to meet his burden of proof, the application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, arguing that his injuries warranted removal from the Minor Injury Guideline (MIG) due to pre-existing conditions, psychological impairments, and chronic pain.

The Tribunal found that the applicant failed to provide compelling medical evidence that his pre-existing back injury precluded recovery within the MIG.

Furthermore, the Tribunal was not persuaded that the applicant suffered a psychological impairment or chronic pain with functional impairment as a direct result of the subject accident.

Consequently, the applicant's injuries were deemed predominantly minor.

The Tribunal ordered that the applicant is entitled to the disputed treatment plans only up to the remaining amount of the $3,500 MIG limit, as such benefits are deemed reasonable and necessary under s. 40(8) of the Schedule.

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

The applicant argued that pre-existing back pain was exacerbated by the accident, warranting removal from the MIG.

The Tribunal found insufficient compelling medical evidence that the pre-existing condition precluded recovery within the MIG.

The applicant's injuries were deemed predominantly minor, and she was entitled only to the remaining balance of the $3,500 MIG limit for the disputed treatment plans.

The applicant requested a reconsideration of a previous Licence Appeal Tribunal decision that found her injuries were predominantly minor and denied her claims for income replacement benefits and medical benefits.

The applicant argued the Tribunal breached procedural fairness and made errors of law by misapprehending psychological evidence and applying the wrong test.

The Adjudicator dismissed the request, finding no breach of procedural fairness and no error of law, as the original decision properly weighed the lack of objective medical evidence from the applicant's family doctor against the reports of assessing practitioners.

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

The insurer denied several 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 she should be removed from the MIG due to psychological impairment, pre-existing conditions, and chronic pain.

The Tribunal found insufficient objective medical evidence to support removal from the MIG, noting a lack of psychological complaints to her family doctor for over two years post-accident and placing greater weight on the insurer's psychological assessment which included validity testing.

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

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied her entitlement to income replacement benefits (IRBs).

She argued the Tribunal violated procedural fairness and made an error of law by applying the post-104 week test instead of the pre-104 week test.

The Tribunal dismissed the request, finding that the period in dispute was entirely post-104 weeks, the applicant had ample notice and opportunity to present her case, and the correct legal test was applied.

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

Following the hearing, the respondent's own assessors conducted a Catastrophic Multidisciplinary Assessment and concluded the applicant met the catastrophic threshold under Criterion 8.

The Tribunal admitted this new evidence under Rule 18.2(d), finding it could not have been obtained previously and would have affected the result.

The Tribunal varied its decision, finding the applicant catastrophically impaired based on the new medical evidence.

The applicant sought statutory accident benefits following an alleged motor vehicle accident.

The respondent insurer denied the claim, alleging the accident was staged and that the applicant made a material misrepresentation.

At a preliminary issue hearing, the adjudicator found the applicant credible and rejected the respondent's expert reconstruction evidence, concluding that an accident did occur and no material misrepresentation was made.

The applicant's request for costs was denied as the respondent's conduct in bringing the preliminary issue was not found to be unreasonable, frivolous, vexatious, or in bad faith.

The applicant sought statutory accident benefits following a 2012 motor vehicle accident, claiming she sustained a catastrophic impairment due to mental and behavioural disorders.

The Licence Appeal Tribunal found that the applicant suffered a Marked impairment in both adaptation and concentration, persistence, and pace, satisfying Criterion 8 of the Schedule.

The Tribunal relied on the evidence of the applicant's treating professionals and experts, preferring them over the insurer's assessors who provided insufficient analysis.

The applicant was awarded attendant care benefits and a treatment plan for psychotherapy.

However, the Tribunal declined to order a special award under s. 10 of O. Reg. 664, finding the insurer's reliance on its medical assessments was not unreasonable.

The applicant sought statutory accident benefits following a motor vehicle accident, which were denied by the respondent insurer.

The matter was scheduled for a videoconference hearing.

Neither the applicant nor her counsel attended the hearing, despite receiving notice.

Pursuant to section 7(3) of the Statutory Powers Procedure Act, the adjudicator proceeded in the applicant's absence.

As the applicant failed to present any evidence to satisfy her burden of proving entitlement to the disputed benefits, the application was dismissed.