Robert Rock

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that found she was not removed from the Minor Injury Guideline (MIG) based on a pre-existing condition.

The applicant argued the Tribunal made errors of law and fact, and sought to introduce new medical evidence.

The adjudicator dismissed the request, finding no legal errors in the original analysis of the medical evidence and concluding that the new evidence did not meet the strict test for reconsideration under Rule 18.2.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to non-earner benefits and various treatment plans outside the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG based on pre-existing conditions, chronic pain, and psychological impairments.

The Tribunal found that the applicant failed to prove on a balance of probabilities that his injuries warranted removal from the MIG, preferring the respondent's insurer examination reports which found no compelling evidence of chronic pain or a psychological condition.

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

The application was dismissed in its entirety.

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 that the applicant failed to prove on a balance of probabilities that she suffered from chronic pain with a functional impairment or a psychological condition warranting removal from the MIG.

The Tribunal also found the applicant was not entitled to a non-earner benefit as she did not demonstrate a complete inability to carry on a normal life.

The application was 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 sought removal from the MIG, claiming she suffered from chronic pain with a functional impairment and a psychological condition.

The Tribunal found the applicant did not meet her burden of proof.

The chiropractor's diagnosis of chronic pain was rejected as it was outside their scope of practice, and the psychological report lacked psychometric testing to substantiate its provisional diagnosis.

The application was dismissed, and the claims for a chiropractic treatment plan and interest were denied.

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

The Tribunal found the applicant failed to prove on a balance of probabilities that he suffered from either condition, noting his family doctor and psychiatrist consistently attributed his anxiety to his daughter's health rather than the accident.

As the applicant remained within the MIG, his claims for various treatment plans exceeding the funding limits, as well as claims for a special award and interest, were dismissed.

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

The Licence Appeal Tribunal found that the applicant failed to demonstrate the assessment was reasonable and necessary.

The only medical evidence relied upon by the applicant, a physiatry report, concluded that the applicant had reached maximal recovery and that the treatment plan was not reasonable or necessary.

Consequently, the claim for a special award was also dismissed.

The applicant was injured in a motor vehicle accident and sought removal from the Minor Injury Guideline (MIG) due to chronic pain and a psychological condition, as well as approval for a $2,200 psychological assessment.

The Tribunal found that the applicant failed to provide compelling medical evidence of a more than minor injury, chronic pain with functional impairment, or a psychological condition warranting removal from the MIG.

The Tribunal preferred the respondent's psychological assessment over the applicant's, finding no reliable evidence of an accident-related psychological impairment.

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 chronic pain and psychological impairments.

The respondent denied the benefits, relying on medical assessments indicating the injuries were minor sprains and strains.

The Licence Appeal Tribunal found that the applicant failed to provide compelling medical evidence to substantiate his claims of chronic pain or a psychological condition.

The Tribunal preferred the respondent's expert evidence, which found the applicant's physical and psychological symptoms did not meet the threshold for MIG removal.

Consequently, the applicant remained subject to the $3,500 MIG limit, and his claims for additional treatment plans, interest, and a special award were dismissed.

The applicant sought accident benefits following a motor vehicle accident, arguing his injuries warranted removal from the Minor Injury Guideline (MIG) due to chronic pain with a functional impairment.

The Licence Appeal Tribunal found the applicant failed to prove on a balance of probabilities that his chronic pain was caused by the accident, noting clinical records attributed his back pain to other sources.

As the applicant remained subject to the MIG limit, his claim for a $2,195.00 physiotherapy treatment plan was dismissed, along with claims for a special award and 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 chronic pain and a psychological condition.

The Licence Appeal Tribunal found that the applicant failed to provide compelling medical evidence of chronic pain with a functional impairment or a psychological condition caused by the accident.

The Tribunal preferred the respondent's independent medical and psychological evaluations, which concluded the injuries were minor and subclinical.

As the applicant remained subject to the MIG and the limits were exhausted, the claims for various treatment plans and assessments were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to psychological and chronic pain assessments outside the Minor Injury Guideline (MIG).

The respondent denied the benefits, arguing the injuries were predominantly minor.

The Tribunal found the applicant failed to prove on a balance of probabilities that she suffered from chronic pain with a functional impairment or an accident-related psychological condition, noting compelling evidence of malingering from the respondent's psychological expert.

The application was dismissed, and claims for the assessments, a special award, and interest were denied.

The applicant sought statutory accident benefits following a 2017 motor vehicle accident.

The Licence Appeal Tribunal dismissed the application in its entirety.

The Tribunal found the insurer correctly paid the psychotherapist rate rather than the psychologist rate for psychological services.

The claim for a chronic pain management program was dismissed because the treatment plan was submitted too late to be completed within the 5-year maximum entitlement period, and causation was not proven.

The claim for an orthopaedic mattress was barred by res judicata, as it had been denied in a prior Tribunal decision between the same parties.

Claims for an award and interest were also dismissed as no benefits were overdue.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits.

The respondent denied a treatment plan for chiropractic services on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued that the respondent failed to comply with the notice requirements under s. 38(8) of the Schedule.

The Tribunal found that the respondent provided timely and compliant notices with medical reasons for the denials.

The Tribunal further held that the applicant failed to provide compelling medical evidence to demonstrate that her injuries warranted removal from the MIG.

The application 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 with a functional impairment.

The Licence Appeal Tribunal reviewed the medical evidence, including assessments from both the applicant and the insurer.

The Tribunal found the applicant's evidence of chronic pain uncompelling, preferring the insurer's assessments which indicated normal range of motion and minor sprain/strain injuries.

The Tribunal concluded the applicant did not suffer from chronic pain with a functional impairment, remained subject to the MIG, and was therefore not entitled to the disputed treatment plans or interest.

The applicant sought entitlement to statutory accident benefits for three treatment plans (chiropractic, physiotherapy, and aquatherapy) following a motor vehicle accident.

The respondent denied the benefits.

The Tribunal found that the applicant failed to establish a causal link between the accident and her ongoing complaints, noting that her pre-existing conditions were similar to her post-accident complaints and that objective medical evidence did not support an accident-related impairment.

The application was dismissed and no interest was payable.

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

The Tribunal first addressed preliminary issues, finding that the applicant's claim for a $4,031.07 treatment plan was statute-barred for missing the two-year limitation period under s. 56 of the Schedule.

The Tribunal denied the respondent's request for costs and allowed the applicant's late-filed medical records into evidence.

On the substantive issues, the Tribunal held that the applicant failed to prove his injuries fell outside the Minor Injury Guideline (MIG) or that a pre-existing injury precluded his recovery within the MIG.

Consequently, the applicant was not entitled to the disputed physiatry assessment, interest, or a special award.

The application was dismissed.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits.

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

The applicant applied to the Licence Appeal Tribunal, arguing for removal from the MIG due to chronic pain and psychological impairments.

The Tribunal found that the applicant failed to meet the burden of proving chronic pain with a functional impairment under the AMA Guidelines, noting normal physical exams and lack of compelling evidence of functional decline.

The Tribunal also found insufficient evidence of a psychological condition, citing multiple assessments indicating symptom exaggeration and malingering.

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

The applicant sought statutory accident benefits for chiropractic and physiotherapy treatments following a 2017 motor vehicle accident.

The adjudicator dismissed the application, finding that the applicant failed to prove the proposed chiropractic treatment was reasonable and necessary, as medical records largely attributed her pain to occupational stress and age-related wear and tear rather than the accident.

The claim for physiotherapy was also dismissed because the expense was incurred before a treatment plan was submitted, contrary to section 38(2) of the Schedule, and no exceptions applied.

As no benefits were payable, the claim for interest was denied.

The applicant sought statutory accident benefits following a motor vehicle accident but was denied by the respondent insurer, who argued her injuries fell within the Minor Injury Guideline (MIG).

The applicant applied to the Licence Appeal Tribunal, arguing her pre-existing neck and back pain and headaches precluded her recovery within the MIG.

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

Consequently, the applicant remained subject to the MIG limit, and her claims for a chiropractic treatment plan, interest, and a special award were dismissed.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits, which were denied by the respondent insurer.

The applicant applied to the Licence Appeal Tribunal for entitlement to various treatment plans, an attendant care assessment, and the cost of an accounting report for an income replacement benefit calculation.

The Tribunal found that the applicant failed to prove on a balance of probabilities that the treatment plans and assessments were reasonable and necessary, noting a lack of supporting medical evidence and reliance on an insurer's examination that concluded the applicant had reached maximum medical recovery.

The Tribunal also denied the cost of the accounting report because the applicant had not submitted the required disability certificate to establish entitlement to income replacement benefits.

The application was dismissed.