21 total
Applicant removed from Minor Injury Guideline due to concussion but denied disputed treatment plans.
The applicant sought statutory accident benefits following a motor vehicle accident.
The Tribunal found that the applicant sustained a concussion and should be removed from the Minor Injury Guideline (MIG).
However, the Tribunal denied the applicant's claims for a physiotherapy treatment plan and a physiatry assessment, finding that the applicant failed to provide compelling contemporaneous evidence that the proposed treatments were reasonable and necessary.
Claims for interest and an award were also denied.
Tribunal awards partial funding for chronic pain management program but denies duplicative assessment and special award.
The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming entitlement to a chronic pain assessment and a chronic pain management program.
The Tribunal found the chronic pain assessment was not reasonable and necessary as it duplicated a previous assessment.
However, the Tribunal found the chronic pain management program was reasonable and necessary, awarding a portion of the outstanding balance, as the evidence showed the accident exacerbated the applicant's pre-existing chronic pain.
The claim for a special award under s. 10 of Regulation 664 was dismissed.
Reconsideration denied; no error of law or fact in finding applicant's injuries fell within MIG.
The applicant requested a reconsideration of a Licence Appeal Tribunal decision that found his injuries fell within the Minor Injury Guideline (MIG).
The applicant argued the Tribunal erred in preferring the respondent's medical evidence over his own experts and in its assessment of his pre-existing back pain and chronic pain.
The adjudicator found no significant error of law or fact, noting that the original decision appropriately weighed the medical evidence, including the timing of the assessments and the applicant's own medical records.
The request for reconsideration was denied.
Application for accident benefits dismissed; applicant failed to prove injuries warranted removal from Minor Injury Guideline.
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 for removal from the MIG based on pre-existing lower back pain and chronic pain.
The Tribunal found that the applicant failed to demonstrate a pre-existing condition that would preclude maximal medical recovery within the MIG, preferring the respondent's medical examination which found normal range of motion and no functional limitations.
The application was dismissed.
The applicant argued for removal from the MIG due to pre-existing chronic shoulder pain and a post-accident chronic pain diagnosis.
The Tribunal found insufficient evidence of a pre-existing condition precluding recovery within the MIG.
The Tribunal preferred the respondent's medical examination, conducted seven months post-accident, over the applicant's assessment conducted 37 months post-accident, concluding the injuries were predominantly minor.
Elderly defendant ordered to complete remote oral discovery; hearsay medical notes insufficient to excuse attendance.
The plaintiff brought a motion to compel the 90-year-old defendant to complete his oral examination for discovery via Zoom.
The defendant opposed, citing advanced age, health issues, and alleged misconduct by plaintiff's counsel during the initial discovery.
The court found the medical evidence to be unpersuasive hearsay and rejected the allegations of counsel misconduct as scandalous and unsupported by the transcript.
The court held that the defendant failed to meet the high onus required to be excused from oral discovery and ordered the examination to resume with accommodations.
Reconsideration request dismissed as untimely and for failing to establish an error of law or fact.
The applicant requested a reconsideration of a decision finding her injuries fell within the Minor Injury Guideline (MIG) and denying her disputed treatment plans.
The adjudicator dismissed the request, finding it was filed 17 days past the 21-day deadline without a valid explanation.
Furthermore, the adjudicator refused to admit a new rebuttal report from the applicant's specialist, noting it could have been obtained prior to the initial hearing and its admission would be procedurally unfair.
Finally, the adjudicator found no error of law or fact in the original causation analysis.
Reconsideration dismissed; applicant failed to show errors in Tribunal's Minor Injury Guideline analysis.
The applicant requested a reconsideration of a Licence Appeal Tribunal decision that found his accident-related injuries fell within the Minor Injury Guideline (MIG).
The applicant argued the Tribunal erred in its application of the pre-existing condition test, its assessment of his degenerative changes, its weighing of a chronic pain assessment, and by failing to mention certain clinical records.
The Vice-Chair dismissed the reconsideration request, finding no errors of law, fact, or procedural fairness.
The Tribunal correctly concluded that the applicant failed to provide compelling medical evidence that his pre-existing conditions would prevent maximal recovery within the MIG limit, and properly weighed the medical evidence before it.
Request for reconsideration of income replacement benefit denial dismissed; no error of law or fact found.
The applicant requested a reconsideration of a decision denying him an income replacement benefit.
He argued the Tribunal erred in law by improperly applying the but-for test and erred in fact by placing too much weight on his pre-existing condition rather than his experts' opinions regarding his chronic pain syndrome.
The adjudicator dismissed the request, finding that the but-for test was properly applied to determine causation and that the weighing of evidence was within the hearing adjudicator's prerogative.
Application for medical benefits dismissed as injuries fell within the Minor Injury Guideline.
The applicant sought medical benefits for injuries sustained in a motor vehicle accident.
The respondent denied the benefits, arguing the injuries fell within the Minor Injury Guideline (MIG).
The applicant argued he suffered from chronic pain and had pre-existing conditions that justified removal from the MIG.
The Tribunal found the medical evidence established only minor, soft tissue injuries.
The Tribunal rejected the applicant's chronic pain assessment as it was conducted virtually and unsupported by objective evidence.
The applicant also failed to provide compelling evidence that his pre-existing conditions would prevent his recovery within the MIG.
Jury notice struck due to pandemic delays to avoid prejudice to the plaintiff.
The plaintiff brought a motion to strike the defendants' jury notice in a trip and fall action due to ongoing delays caused by the COVID-19 pandemic.
The court granted leave to bring the motion after the action was set down for trial, finding the pandemic constituted a substantial and unexpected change in circumstances.
Applying a five-factor analysis, the court concluded that the plaintiff would suffer prejudice from further delay and that justice was better served by discharging the jury.
The motion was granted, with leave for the defendants to seek reinstatement if jury trials are permitted when the matter is called.
Application for accident benefits allowed in part; only the in-home assessment was deemed reasonable and necessary.
The applicant was injured in a motor vehicle accident and sought various medical benefits and costs of examinations under the Statutory Accident Benefits Schedule.
The insurer denied the claims, arguing they were not reasonable and necessary.
The Licence Appeal Tribunal reviewed the proposed treatment plans, which included assistive devices, a biopsychosocial assessment, a chiropractic concussion assessment, a workplace assessment, an attendant care assessment, an in-home assessment, and a chronic pain assessment.
The Tribunal found that the applicant failed to meet her burden of proof for most of the claims, noting a lack of objective medical evidence and issues with the scope of practice for the chiropractic concussion assessment.
However, the Tribunal concluded that the in-home assessment was reasonable and necessary to evaluate the applicant's ability to perform everyday home-related tasks.
The application was allowed in part, with the insurer ordered to pay for the in-home assessment plus interest.
Application for accident benefits dismissed; injuries fell within the Minor Injury Guideline funding limit.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits for physiotherapy and chiropractic services.
The respondent denied the treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and she had exhausted the $3,500 funding limit.
The applicant argued her pre-existing back and shoulder conditions were exacerbated, precluding recovery within the MIG.
The Tribunal found no compelling evidence that the pre-existing conditions were exacerbated by the accident or prevented recovery.
The Tribunal preferred the insurer's medical examination report over the applicant's orthopaedic assessment, which was historically inaccurate.
The Tribunal concluded the applicant sustained a minor injury, had exhausted her MIG funding, and was not entitled to the disputed benefits or interest.
Income replacement benefit claim dismissed due to lack of objective medical evidence of substantial inability to work.
The applicant sought an income replacement benefit (IRB) of $400 per week following a motor vehicle accident, claiming psychological and physical impairments prevented him from performing his essential tasks as an AutoCAD technician.
The respondent denied the claim, arguing the applicant returned to work immediately, was terminated for being a poor fit, and lacked objective medical evidence of disability.
The Licence Appeal Tribunal dismissed the application, finding the applicant failed to provide contemporaneous, objective medical evidence demonstrating a substantial inability to perform his pre-accident employment tasks during the disputed period.
As no benefits were payable, the claim for interest was also dismissed.
Reconsideration request dismissed; no error of law or fact in finding injuries fell within MIG.
The applicant requested a reconsideration of a decision finding his injuries fell within the Minor Injury Guideline (MIG) and denying his claim for income replacement benefits.
The applicant argued the adjudicator failed to properly consider medical evidence and pre-existing conditions.
The Vice Chair dismissed the request, finding no errors of law or fact in the original decision.
The adjudicator had properly weighed the evidence and the applicant was attempting to reargue his case, which is not permitted on reconsideration.
Income replacement benefit denied as applicant's inability to work was caused by pre-existing severe osteoarthritis.
The applicant sought entitlement to an income replacement benefit following a motor vehicle accident.
Prior to the accident, the applicant was unable to work due to severe bilateral knee osteoarthritis and was awaiting knee replacement surgery.
The applicant argued that the accident aggravated his condition and caused chronic pain syndrome, satisfying the 'but for' test for causation.
The Tribunal found that the applicant was already substantially unable to perform the essential tasks of his pre-accident employment prior to the accident due to his unresolved knee issues.
The application was dismissed, as the applicant failed to establish that his inability to work was caused by the accident.
Application for accident benefits dismissed; injuries fell within MIG and no entitlement to IRB proven.
The applicant sought accident benefits following a motor vehicle accident.
The respondent determined the applicant's injuries fell within the Minor Injury Guideline (MIG) and terminated his income replacement benefits (IRB).
The Tribunal found that the applicant's physical injuries were predominantly minor, consisting of sprains and strains, and that he failed to prove he suffered from chronic pain.
The Tribunal also found the applicant was not entitled to an IRB, as there was insufficient medical evidence to establish a substantial inability to perform the essential tasks of his pre-accident employment.
Insurer's request for reconsideration denied; Tribunal made no significant error in awarding ongoing income replacement benefits.
The respondent insurer requested a reconsideration of a Tribunal decision that found the applicant entitled to pre- and post-104 week income replacement benefits (IRBs) due to psychological injuries sustained in a motor vehicle accident.
The insurer argued the Tribunal erred in law and fact by misapplying the IRB tests and misinterpreting the medical evidence, particularly given the applicant's non-disclosure of marital issues to assessors.
The Vice Chair denied the reconsideration request, finding that the Tribunal correctly applied the legal tests and that its conclusions regarding the applicant's complete inability to work were well-supported by the psychological evidence.
Applicant awarded ongoing income replacement benefits due to accident-related psychological impairments preventing employment.
The applicant sought income replacement benefits (IRBs) following a motor vehicle accident.
The insurer terminated IRBs after 104 weeks, arguing the applicant did not meet the test for complete inability to work.
The Tribunal found that while the applicant failed to prove physical impairment, he successfully established that his psychological impairments, caused by the accident, rendered him completely unable to engage in any employment for which he was reasonably suited.
The Tribunal awarded IRBs from November 15, 2015, ongoing, with interest.
The respondent's request for costs was denied.
Applicant removed from Minor Injury Guideline due to psychological impairment and chronic pain syndrome; IRBs awarded.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits.
The insurer denied income replacement benefits, a medical benefit, and the cost of a psychological assessment, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Licence Appeal Tribunal found that the applicant's injuries were not minor, as he suffered from a psychological impairment and chronic pain syndrome that could not be treated within the $3,500 MIG limit.
The Tribunal awarded income replacement benefits up to the 104-week mark, finding the applicant suffered a substantial inability to perform the essential tasks of his pre-accident employment.
The Tribunal also awarded the cost of a psychological assessment but denied the remaining balance for a physiotherapy treatment plan because the massage therapy rate exceeded the FSCO guideline limit.