Rupinder Hans

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

The Tribunal found the applicant entitled to a $3,349.08 chiropractic treatment plan, as medical evidence supported that pain reduction was a reasonable and necessary goal.

However, a subsequent $2,585.50 chiropractic plan was denied because the applicant failed to attend a reasonably necessary insurer examination, precluding her from proceeding to a hearing on that issue.

A psychiatric assessment was denied because it was incurred before the treatment plan was submitted.

The respondent conceded entitlement to a physiatry assessment.

Interest was awarded on the overdue benefits.

The applicant was injured in a motor vehicle accident and received income replacement benefits (IRBs) from the respondent insurer.

The insurer terminated the IRBs, and the applicant appealed to the Licence Appeal Tribunal seeking IRBs for a disputed period of approximately three weeks before she returned to work.

The Tribunal found that the applicant failed to provide contemporaneous medical evidence demonstrating a substantial inability to perform the essential tasks of her pre-accident employment as a hairdresser.

Relying on the respondent's multidisciplinary independent medical examination, the Tribunal dismissed the claim for IRBs, interest, and costs.

The applicant, a letter carrier, was struck in the head by a cyclist while standing on the sidewalk retrieving mail from her parked work vehicle.

She applied for statutory accident benefits, which the insurer denied on the basis that the incident did not meet the definition of an 'accident' under section 3(1) of the Schedule.

The Tribunal found that the applicant's body made contact with the vehicle after being struck by the cyclist.

Applying the Amos and Greenhalgh tests, the Tribunal concluded that the purpose test was met as the applicant was engaged in an ordinary activity attached to a vehicle.

The causation test was also met because the use and operation of the vehicle was a direct cause of the injuries, and the cyclist was not an intervening act that broke the chain of causation.

The Tribunal ordered that the incident was an accident.

The applicant was injured in a motor vehicle accident and sought income replacement benefits (IRBs).

The respondent insurer terminated IRBs after initially paying them, arguing the applicant could return to her pre-accident employment as a furniture salesperson.

The Tribunal found that the applicant's physical impairments, including exacerbated pre-existing degenerative conditions, and psychological impairments rendered her substantially unable to perform the essential tasks of her employment, which included prolonged standing, walking, and lifting furniture.

The Tribunal ordered the respondent to pay the weekly IRB of $336.45 from the date of termination, plus interest.

The applicant was involved in a motor vehicle accident and sought medical benefits for physiotherapy, massage therapy, and a psychological assessment.

The respondent denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline and the $3,500 limit had been reached.

The Tribunal found that the applicant's injuries were predominantly minor and that she failed to establish a pre-existing medical condition that would prevent maximal recovery under the Guideline.

The application for benefits and an award for unreasonable delay was dismissed.

The applicant sought medical benefits for occupational therapy services and assistive devices following a motor vehicle accident.

The insurer denied the treatment plans and requested the applicant attend insurer's examinations (IEs).

The applicant refused to attend, arguing the insurer failed to provide valid medical reasons for the IEs as required by the Statutory Accident Benefits Schedule.

The Tribunal found that the insurer had provided valid medical reasons for requiring the IEs, such as the need to assess the applicant's living situation and current mattress.

Because the applicant failed to attend the scheduled IEs, section 55 of the Schedule precluded him from applying to the Tribunal for dispute resolution.

The application was dismissed in its entirety, along with claims for a special award, interest, and costs.

The applicant sought statutory accident benefits for injuries sustained in a motor vehicle accident, arguing that a pre-existing low back condition exempted him from the Minor Injury Guideline.

The Tribunal found insufficient medical evidence to establish a pre-existing condition that would prevent maximal recovery within the Guideline, noting that most of the applicant's medical evidence post-dated a second motor vehicle accident.

Consequently, the Tribunal held that the applicant's injuries were predominantly minor, and his claims for prescription medications were denied as he had exhausted the Guideline's monetary limits.

The applicant sought entitlement to a non-earner benefit, attendant care benefits, and medical benefits for dental services and a TMJ assessment following a motor vehicle accident.

The Licence Appeal Tribunal dismissed all claims.

The adjudicator found the applicant failed to provide a pre-accident baseline to establish a complete inability to carry on a normal life for the non-earner benefit.

The attendant care claim was denied because the applicant failed to prove the expenses were incurred, relying on non-contemporaneous expense sheets.

The medical benefits were denied due to insufficient evidence establishing a causal link between the accident and the dental/TMJ issues.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for a chronic pain management program and an orthopaedic assessment.

The respondent insurer denied the treatment plans, arguing they were not reasonable or necessary.

The Licence Appeal Tribunal found the applicant's medical evidence, which included diagnoses of chronic pain syndrome and recommendations for multidisciplinary treatment, to be more persuasive than the insurer's assessments.

The Tribunal ordered the respondent to pay for the chronic pain program and the orthopaedic assessment, along with interest on incurred expenses.

However, the Tribunal dismissed the applicant's claim for a special award under Regulation 664, finding no evidence that the insurer acted unreasonably or in bad faith.

The applicant was injured in a motor vehicle accident and sought income replacement benefits (IRBs) and medical benefits for physiotherapy and assistive devices.

The Licence Appeal Tribunal found that the applicant was substantially unable to perform the essential tasks of his pre-accident employment as a marble shop worker, which involved medium physical demand level work, and granted the IRBs.

However, the Tribunal denied the medical benefits for physiotherapy due to a lack of specificity in the treatment plan, and denied the assistive devices because there was no evidence linking the applicant's foot pathology to the accident.

Interest was awarded on the overdue IRBs.

The applicant was struck by a motor vehicle as a pedestrian and sought statutory accident benefits for chiropractic services.

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

The Licence Appeal Tribunal found that the applicant's injuries, which included chronic pain, fell outside the MIG based on the detailed medical evidence of her chronic pain specialist.

The Tribunal ordered the respondent to pay the disputed medical benefits, finding them reasonable and necessary, along with interest on the overdue amounts.