Robert Fleming

The applicant sought entitlement to a $2,400 chiropractic assessment following a 2018 motor vehicle accident.

The respondent denied the benefit.

The Tribunal found that the treatment plan was submitted more than 260 weeks after the accident, barring the claim under section 20(1)(a) of the Statutory Accident Benefits Schedule.

Because no substantive benefits remained in dispute, the Tribunal held it lacked jurisdiction to determine whether the applicant's injuries fell within the Minor Injury Guideline as a standalone issue.

The application was dismissed.

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

The respondent denied the treatment plans.

The Tribunal found that the applicant failed to prove the physiotherapy treatment plan was reasonable and necessary, noting a lack of corroborating medical evidence beyond the OCF-18 itself.

The Tribunal also dismissed the claims for the balance of psychological services, finding the applicant did not establish that a psychotherapist or social worker should be paid at the higher hourly rate of a psychologist.

Claims for interest and a special award were dismissed.

The applicant was injured in a motor vehicle accident and sought entitlement to statutory accident benefits for massage therapy and chiropractic services, which the respondent insurer denied.

The Licence Appeal Tribunal found that the treatment plans were reasonable and necessary, preferring the evidence of the applicant's occupational therapist who conducted a comprehensive in-home assessment over the insurer's independent medical examination.

The Tribunal also dismissed the applicant's preliminary motion to strike the respondent's late-filed written submissions, finding no prejudice to the applicant.

The applicant was awarded the disputed treatment plans and interest on overdue payments.

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

The adjudicator found the applicant did not meet her burden to establish removal from the MIG, noting her high level of functioning, return to full-time work, and lack of corroborating medical evidence for her psychological claims.

As the applicant remained within the MIG, the disputed treatment plans were denied and no interest was payable.

The applicant sought statutory accident benefits following a 2018 motor vehicle accident.

The respondent denied various 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 for removal from the MIG due to chronic pain and a psychological condition.

The Tribunal found insufficient medical evidence to support chronic pain with functional impairment or a psychological condition, noting a subsequent 2019 accident and a lack of continuous medical documentation.

The application was dismissed, and claims for treatment plans, a special award, and interest were denied.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to two physiotherapy treatment plans and removal from the Minor Injury Guideline (MIG) due to a concussion, elbow, shoulder, and back pain.

The Tribunal found that the applicant failed to meet the burden of proving their injuries fell outside the MIG, noting that the medical records indicated sprains and strains consistent with the MIG definition, and that back pain and headaches were not ongoing.

The applicant was held to remain within the MIG and was entitled only to any remaining funds within the $3,500 limit, plus interest on any overdue payments.