2 total
Claim for income replacement benefits dismissed as applicant failed to prove substantial inability to work.
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.
Tribunal approves chronic pain and physiatry assessments but denies psychological and functional evaluations.
The applicant sought various medical assessments following a 2010 motor vehicle accident.
The respondent insurer denied the assessments.
The Licence Appeal Tribunal found that the chronic pain and physiatry assessments were reasonably required due to consistent medical evidence of ongoing ankle pain and the risk of progressive osteoarthritis.
However, the Tribunal dismissed the claims for work site, psychological, attendant care, and function and impairment assessments, finding insufficient evidence to support their necessity, particularly given the applicant's independence in self-care and lack of documented psychological symptoms prior to 2014.
Interest was awarded on the overdue payments for the approved assessments.
No co-appearing lawyers found.
No judges found.