Stephanie Kepman

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

The respondent denied certain benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued she should be removed from the MIG due to a pre-existing condition (degenerative disc disease).

The Tribunal found that while the applicant had a pre-existing condition, she failed to provide compelling medical evidence that it would prevent her from achieving maximal recovery if subject to the MIG limits.

Consequently, the applicant was not entitled to the disputed medical benefit, interest, or a special award.

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

The respondent denied certain medical 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 a pre-existing condition (Degenerative Disk Disease) and chronic pain.

The Tribunal found that the applicant failed to provide compelling evidence that her pre-existing condition prevented her from reaching maximal recovery within the MIG, noting her family doctor found no change in her condition since before the accident.

The Tribunal also found the applicant did not establish a chronic pain diagnosis meeting the AMA Guides criteria.

As the applicant's injuries were predominantly minor and she had exhausted the $3,500 MIG limit, the application for medical benefits and interest was dismissed.

The applicant sought income replacement benefits and approval for three physiotherapy treatment plans following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove a substantial inability to perform the essential tasks of her sedentary employment as an insurance agent.

The Tribunal preferred the respondent's medical evidence, which found no organic pathology preventing her return to work and concluded that further passive facility-based treatment was not reasonable and necessary.

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

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

The applicant argued for removal from the MIG based on a full thickness shoulder tear, a pre-existing shoulder condition, a psychological injury, and chronic pain.

The Tribunal found that the applicant failed to prove the shoulder tear was caused by the accident, failed to show the pre-existing condition prevented maximal recovery within the MIG limits, and failed to establish a psychological impairment or chronic pain.

Consequently, the applicant's injuries were deemed predominantly minor, and the claims for treatment outside the MIG limits were dismissed.

The appellant appealed the removal of a calf and the associated statement of account under the Provincial Animal Welfare Services Act, 2019.

The Animal Care Review Board found that the calf was in distress due to a colostrum deficiency and inappropriate living conditions, justifying its removal.

The Board declined to return the calf to the appellant, finding that doing so would place the animal in distress given the appellant's failure to acknowledge the calf's health issues or improve its living conditions.

The statement of account for veterinary and boarding fees was confirmed as reasonable.

The applicant was injured in a motor vehicle accident and sought medical benefits for chiropractic and physiotherapy treatments.

The respondent denied the claims 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 a pre-existing connective tissue disease.

The Tribunal found that the applicant failed to provide compelling evidence that her pre-existing condition prevented maximal recovery within the MIG limits, noting that the diagnosis occurred after the accident and was not mentioned in the treatment plans.

The application was dismissed.

The applicant and respondent both requested a reconsideration of a previous Licence Appeal Tribunal decision that awarded the applicant a special award of $550.00 related to a denied physiatry assessment.

The respondent argued the adjudicator erred in law by considering extraneous factors and incorrectly quantifying the award.

The applicant argued the adjudicator erred in calculating the award amount by not including other denied treatment plans.

The adjudicator dismissed both requests, finding that the respondent failed to establish any error of law regarding the special award, and that the applicant's request involved issues not properly raised at the original hearing.

Both the applicant and the respondent requested a reconsideration of a previous Tribunal decision that awarded the applicant a special award of $550.00 related to a denied physiatry examination.

The respondent argued the adjudicator erred in law by considering extraneous factors and concluding a general practitioner was unqualified to assess the need for a physiatry assessment.

The applicant argued the adjudicator erred in calculating the special award amount.

The Tribunal dismissed both requests, finding no error of law or fact, as the respondent failed to explain its decision-making process and the applicant raised issues not properly before the Tribunal at the original hearing.

The appellant appealed a Fire Marshal's review decision confirming an inspector's order regarding her residential property.

The property, originally designed as a single-family dwelling, was being used as a two-unit dwelling with an unregistered basement apartment.

The inspector ordered the appellant to either revert the residence to a single-family dwelling or obtain a building permit for a two-unit dwelling.

The appellant argued that physical modifications she made to the property mitigated the fire risk, rendering it compliant with the Fire Code without a building permit.

The Fire Safety Commission dismissed the appeal, finding that the modifications did not satisfy section 2.1.2.2 of the Fire Code and the property remained a fire hazard because its use was contrary to its original design and no building permit had been obtained.

The applicant sought ongoing income replacement benefits, a special award, interest, and costs following a motor vehicle accident.

The insurer had initially terminated the applicant's income replacement benefits based on Insurer Examinations placing her within the Minor Injury Guideline, but later reinstated them after receiving additional medical records.

The Tribunal held it lacked jurisdiction under section 281 of the Insurance Act to order ongoing benefits after reinstatement.

The Tribunal dismissed the claim for a special award under Regulation 664, finding the adjuster acted properly based on the medical evidence available at the time.

Claims for interest and costs were also dismissed.

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

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

The Tribunal found that the applicant's physical injuries, including neck and back strain, were predominantly minor.

The Tribunal also found that the applicant did not suffer a psychological impairment that would remove her from the MIG, preferring the respondent's psychological assessment over the applicant's due to the latter's failure to consider relevant clinical notes and the applicant's non-disclosure of alcohol use.

The application for medical and rehabilitation benefits and interest was dismissed.

The applicant was injured in a motor vehicle accident and sought a medical benefit of $2,314.48 for a physiotherapy treatment plan.

The respondent denied the claim.

The Licence Appeal Tribunal found that the applicant failed to prove the treatment was reasonable and necessary, noting that her treating physicians had not recently recommended passive therapy and an insurer's examination concluded she had reached maximum therapeutic improvement.

The application was dismissed and no interest was awarded.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for a multi-disciplinary chronic pain management treatment plan and two physiotherapy treatment plans.

The adjudicator found the chronic pain management treatment plan to be reasonable and necessary, relying on the applicant's orthopaedic expert who established a direct causal relationship between the accident and the applicant's severe chronic pain.

However, the adjudicator dismissed the claims for the physiotherapy treatment plans, noting that the applicant had reached maximal medical recovery from a musculoskeletal perspective and that the chronic pain program already included multiple body sites therapy.

The applicant was awarded interest on the overdue chronic pain benefit.

The applicant sought income replacement benefits, medical and rehabilitation benefits, and a catastrophic impairment determination following a 1997 motor vehicle accident.

The respondent raised a preliminary issue regarding the Tribunal's jurisdiction, arguing the applicant never submitted a completed Application for Accident Benefits (OCF-1).

The Tribunal found that because the applicant never filed an OCF-1, no benefits were ever denied by the insurer.

Consequently, the Tribunal lacked jurisdiction to hear the dispute.

The application was dismissed.

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

The applicant failed to provide any submissions or evidence for the written hearing and did not respond to correspondence from the Tribunal or the respondent.

The Tribunal found that the applicant had not met the evidentiary burden to prove entitlement to the claimed benefits and dismissed the application.

The applicant sought payment for a physiatry assessment following a motor vehicle accident that resulted in a traumatic brain injury.

The respondent insurer denied the cost, relying on an assessment by a general practitioner.

The Licence Appeal Tribunal found the physiatry assessment was reasonable and necessary, preferring the evidence of the applicant and her treating professionals.

The Tribunal also found the insurer unreasonably withheld benefits due to multiple errors in handling the file, and ordered a 25% special award under Regulation 664, along with interest on the overdue payment.

The applicant requested a reconsideration of a previous Tribunal decision that denied income replacement benefits, removal from the Minor Injury Guideline, and payment for treatment plans.

The applicant argued the adjudicator erred in law in interpreting section 38 of the Statutory Accident Benefits Schedule regarding the insurer's notice of denial, and that the adjudicator's failure to consider illegible clinical notes was grossly unfair.

The adjudicator dismissed the request, finding no error of law in the interpretation of section 38, as the treatment had not been incurred and the insurer eventually provided medical reasons.

Furthermore, the adjudicator held that the illegible notes did not constitute new evidence, as the applicant could have arranged for their transcription prior to the hearing.

The applicant was injured in a motor vehicle accident and sought medical, rehabilitation, and income replacement benefits.

The respondent denied the claims, arguing the injuries fell within the Minor Injury Guideline (MIG) and the applicant did not suffer a substantial inability to perform her employment tasks.

The Tribunal found that the applicant's physical injuries were predominantly minor and that she failed to prove her pre-existing conditions, psychological impairments, or chronic pain removed her from the MIG.

As the MIG limits were exhausted, the medical benefits were denied.

The Tribunal also dismissed the claim for an income replacement benefit, finding the applicant returned to work shortly after the accident and failed to demonstrate a substantial inability to perform the essential tasks of her employment.

The applicant insurer sought repayment of $10,424.23 in income replacement benefits (IRBs) paid to the respondent, arguing the benefits were paid in error after the respondent had returned to full-time employment.

The respondent did not attend the hearing.

The Adjudicator found that the respondent was overpaid IRBs in error and that the insurer provided notice of the overpayment within the required 12-month period under section 52 of the Statutory Accident Benefits Schedule.

The respondent was ordered to repay the IRBs along with interest.

The applicant sought statutory accident benefits following a motor vehicle accident, including income replacement benefits (IRBs), removal from the Minor Injury Guideline (MIG), and various medical and rehabilitation benefits.

The Tribunal found the applicant was not entitled to IRBs because he had quit his job prior to the accident and did not qualify for Employment Insurance due to misreporting income.

The Tribunal removed the applicant from the MIG based on psychological impairments identified by both the applicant's and respondent's assessors.

However, the Tribunal denied the claims for chiropractic, massage, and acupuncture treatment, as well as an x-ray, finding them not reasonable and necessary or barred by timing rules.

The claim for a psychological assessment was granted.