Lisa Yong

The applicant sought statutory accident benefits following a motor vehicle accident, claiming her psychological impairment and chronic pain warranted removal from the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that the applicant's injuries were predominantly minor soft-tissue injuries.

The Tribunal preferred the respondent's insurer's examination reports, which found no accident-related psychological condition or functional impairment, over the applicant's unsupported claims.

As the MIG limits were exhausted, the applicant was not entitled to the disputed treatment plans, an award, or interest.

The applicant sought 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 that he suffered from a concussion, psychological impairments, and chronic back pain warranting removal from the MIG.

The Tribunal found insufficient compelling medical evidence to support these claims, preferring the insurer's expert assessments which concluded the injuries were predominantly minor soft tissue injuries with no significant psychological impairment.

The application was dismissed, and the applicant was held to the $3,500 MIG limit, with entitlement to the disputed treatment plans only if already incurred under the MIG.

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 applicant argued she should be removed from the MIG due to psychological impairment and chronic pain with functional impairment.

The Tribunal found that the applicant failed to establish a psychological impairment, preferring the respondent's expert who conducted a more thorough review of the medical records.

The Tribunal also found that while the applicant experienced chronic pain, she failed to demonstrate an accompanying functional impairment, as she had returned to full-time work and remained independent in her daily activities.

As the applicant remained within the MIG and the funding limit was exhausted, the claims for treatment plans, interest, and an award were dismissed.

The applicant sought entitlement to statutory accident benefits for physiotherapy, chiropractic treatment, and a chronic pain assessment following a motor vehicle accident.

The respondent denied the benefits on the basis that the applicant's injuries were minor and he had reached maximum medical improvement.

The Tribunal found that the applicant failed to prove the treatment plans were reasonable and necessary, preferring the respondent's independent medical examination reports which concluded the soft tissue injuries had healed.

The application was dismissed in its entirety.

The applicant sought payment for two chiropractic treatment plans following a motor vehicle accident.

The respondent denied the plans, arguing the injuries fell within the Minor Injury Guideline and the treatments were not reasonable and necessary.

The Tribunal found a lack of compelling and contemporaneous medical evidence to support the applicant's claim, noting that her knee pain was related to pre-existing degenerative changes and she had made no accident-related complaints to her family doctor for several months.

The Tribunal preferred the evidence of the respondent's s. 44 assessor and dismissed the application.

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

The respondent insurer denied the benefits, asserting the injuries were minor and the MIG limits had been exhausted.

As a preliminary issue, the adjudicator struck the applicant's written submissions that exceeded a previously ordered 12-page limit.

On the merits, the adjudicator found insufficient contemporaneous medical evidence to support the applicant's claims of psychological impairment or functional impairment due to chronic pain.

The adjudicator preferred the respondent's insurer examination reports over the applicant's expert assessments, concluding the injuries were predominantly minor.

Because the MIG limits were exhausted, the disputed treatment plans, interest, and an award for unreasonable delay were all denied.

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

The adjudicator denied the claims for medical cannabis and an in-home ergonomic assessment, finding them not reasonable and necessary.

However, the adjudicator approved a work site ergonomic assessment and physiotherapy services based on the recommendations of the applicant's treating physician and medical assessors.

The adjudicator also ordered the respondent to pay for a psychological treatment plan because the respondent's denial letter failed to provide sufficient medical and other reasons, breaching section 38(8) of the Schedule.

The claim for a special award was dismissed.

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

The respondent denied several treatment plans for psychological and physical therapy services on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 funding limit had been exhausted.

The Tribunal found that the applicant failed to provide compelling medical evidence to demonstrate that his physical or psychological injuries warranted removal from the MIG.

The Tribunal preferred the respondent's psychological assessment over the applicant's evidence, noting a lack of objective findings and symptom magnification.

As the MIG limit was exhausted, the application for the disputed treatment plans and interest was dismissed.

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

The Tribunal found that the applicant failed to prove her injuries warranted removal from the Minor Injury Guideline (MIG), as the medical evidence did not establish chronic pain with functional impairment or a psychological condition.

However, the Tribunal ordered the respondent to pay for three disputed treatment plans because the respondent failed to prove it delivered valid denial letters within the required 10 business days under s. 38(8) of the Schedule.

The applicant's claim for an award under s. 10 of Reg. 664 was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming it exacerbated a pre-existing right shoulder injury sustained in a workplace accident two months prior.

The respondent denied treatment plans for a chronic pain assessment and physiotherapy.

The Tribunal found that while the motor vehicle accident was a necessary cause of the applicant's injuries, the disputed treatment plans were not reasonable and necessary.

The applicant was already receiving extensive treatment for her shoulder through a specialized program, and medical evidence indicated she had reached maximal medical recovery for the accident-related soft tissue injuries.

The application was dismissed.

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

The Tribunal found the applicant was entitled to the balance of a treatment plan for driver rehabilitation therapy because the insurer failed to provide sufficient medical reasons for its partial denial, triggering the consequences of section 38(11) of the Schedule.

However, the Tribunal dismissed the claims for chiropractic services and a psychological assessment, finding them not reasonable and necessary based on the medical evidence, including section 44 insurer examinations.

The claim for physiotherapy was also dismissed as the expenses were incurred before a treatment plan was submitted, contrary to section 38(2).

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

The respondent denied various 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 predominantly minor and that he failed to prove any pre-existing condition, psychological impairment, or chronic pain with functional impairment that would warrant removal from the MIG.

As the MIG funding limit was exhausted, the disputed treatment plans were not payable.

The application was dismissed.

The applicant sought payment for a chronic pain assessment following a motor vehicle accident.

The respondent denied the treatment plan and requested an insurer's examination.

The Tribunal found that the respondent's denial notice complied with the requirements of the Statutory Accident Benefits Schedule.

Furthermore, the Tribunal concluded that the applicant failed to prove the assessment was reasonable and necessary, as she had already been diagnosed with chronic pain and was receiving beneficial treatment from a specialist.

The application for the assessment, interest, and an award was dismissed.

The applicant sought payment of $11,780.00 for the balance of catastrophic impairment assessments following a motor vehicle accident.

The respondent had partially approved the assessments up to the $2,000.00 limit per assessment under s. 25(5)(a) of the Schedule but denied additional fees for document review and reports.

The Tribunal found that the applicant failed to meet the onus of proving that the additional costs were reasonable and necessary.

The application for the balance of the assessment costs, an award, and interest was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming her injuries fell outside the Minor Injury Guideline (MIG) due to chronic pain and psychological impairments.

The respondent denied the benefits, arguing the injuries were minor and the $3,500 MIG limit was exhausted.

The Tribunal found the applicant failed to prove her injuries warranted removal from the MIG, noting her treating physicians primarily diagnosed minor sprains and strains, and her psychological complaints arose over a year post-accident.

As the MIG limit was exhausted, the claims for further physiotherapy and psychological assessments were dismissed.

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

The applicant was removed from the Minor Injury Guideline for psychological reasons.

The Tribunal found that only one chiropractic treatment plan, proposed shortly after the applicant began treatment, was reasonable and necessary.

The remaining treatment plans for chiropractic care, psychological services, a functional cognitive assessment, and a chronic pain assessment were denied due to a lack of compelling medical evidence and the applicant's failure to meet the evidentiary burden.

The applicant was awarded the cost of the approved treatment plan plus interest.

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

The Tribunal found insufficient medical evidence to substantiate a concussion or any non-minor physical impairments.

The Tribunal gave little weight to the applicant's psychological report and preferred the respondent's section 44 assessment, which found no objective evidence of psychological impairment.

The Tribunal concluded the applicant's injuries were predominantly minor, dismissing the claims for a psychological assessment, an award for delayed payments, and interest.

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 Tribunal found that the applicant's physical injuries were predominantly minor and that he failed to establish a pre-existing condition or psychological impairment warranting removal from the MIG.

However, the Tribunal found that the respondent failed to comply with the notice requirements under section 38(8) of the Schedule for several treatment plans.

As a result, the respondent was ordered to pay for physiotherapy services incurred during the period of non-compliance and for psychological services due to a defective denial notice that merely referenced a section 44 report without providing it to the applicant.