Dr. A. Belfon

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

The Licence Appeal Tribunal found that the applicant's injuries were predominantly minor soft-tissue injuries.

The Tribunal preferred the respondent's medical assessments, noting that the applicant's contemporaneous medical records did not support a concussion, chronic pain with functional impairment, or a psychological condition.

As the applicant remained within the MIG, the disputed treatment plans were not payable, and claims for interest and a special award were dismissed.

The applicant was struck by a vehicle as a pedestrian and sought statutory accident benefits, including a determination of catastrophic impairment, income replacement benefits (IRBs), and various medical benefits.

The Tribunal found that the applicant did not sustain a catastrophic impairment, as his physical and psychological impairments did not meet the 55% whole person impairment threshold under criteria 6 and 7, nor did he suffer marked impairments in three domains under criterion 8.

The Tribunal also dismissed the claim for IRBs, noting the applicant had returned to work for nearly three years post-accident and failed to demonstrate a complete inability to engage in suitable employment.

Claims for a functional abilities evaluation and worksite assessment were dismissed as not reasonable and necessary.

The applicant was awarded minor amounts for treatment plan form fees and interest on those amounts, but the claim for a special award was dismissed as the insurer's denials were not unreasonable.

The applicant was injured in a rear-end motor vehicle accident and sought statutory accident benefits.

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

The Tribunal allowed late-disclosed medical records into evidence, finding them highly relevant and of little prejudice to the respondent.

Based on evidence that the applicant received nerve block injections for ongoing back pain, the Tribunal concluded she suffered from a chronic pain condition and was not subject to the MIG.

However, the Tribunal dismissed the applicant's claims for specific chronic pain, psychological, and physiotherapy treatment plans, finding she failed to demonstrate they were reasonable and necessary.

Claims for an award and interest were also dismissed.

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

The respondent insurer denied funding for several treatment and assessment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and its $3,500 funding limit.

The applicant claimed to suffer from psychological injuries and chronic pain syndrome, which would remove him from the MIG.

The Licence Appeal Tribunal found no evidence of an accident-related psychological impairment or chronic pain condition, noting the applicant's minimal psychological symptoms, failure to pursue psychological treatment, and return to full-time work.

The Tribunal concluded the applicant sustained a minor injury, is subject to the MIG limit, and is therefore not entitled to the disputed treatment plans, assessment plans, or interest.

The applicant sought statutory accident benefits following a rear-end motor vehicle collision.

The respondent denied funding for chiropractic, physiotherapy, and psychological assessment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued he sustained psychological injuries and chronic pain outside the MIG.

The Licence Appeal Tribunal found insufficient evidence of a psychological injury or accident-related chronic pain, noting pre-existing conditions and relying on insurer's examinations.

The Tribunal concluded the applicant's injuries were minor, subject to the $3,500 MIG limit, and dismissed the claims for the disputed treatment plans, interest, and a section 10 award.

The applicant was injured in a rear-end motor vehicle accident and sought accident benefits for physiotherapy and a chronic pain assessment.

The respondent denied the treatment plans 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 pre-existing back, neck, and shoulder pain, as well as chronic pain caused by the accident.

The Tribunal found that the applicant's pre-existing conditions, which included prior workplace injuries, did not preclude her recovery within the MIG.

The Tribunal preferred the respondent's medical assessment over the applicant's expert, noting the latter failed to address the pre-existing conditions.

The application was dismissed, and the applicant was held to the $3,500 MIG funding limit.

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

The respondent denied funding for several treatment and assessment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The adjudicator found that the applicant failed to prove he suffered from a pre-existing condition, psychological injury, or chronic pain condition that would remove him from the MIG.

Relying on insurer's examinations and the lack of consistent medical complaints, the adjudicator concluded the injuries were predominantly minor.

The application for disputed benefits and interest was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including chiropractic treatment, medication, and assessments for chronic pain and psychological impairments.

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

The Tribunal found that the applicant failed to prove his injuries fell outside the MIG, rejecting claims of chronic pain syndrome, psychological impairment, and a pre-existing condition that prevented maximal recovery.

As the applicant had not exhausted the $3,500 limit, the disputed treatment plans and assessments were denied, and the application was dismissed.

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

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

The Licence Appeal Tribunal found that the applicant sustained psychological injuries that removed her from the MIG.

The Tribunal ordered the insurer to pay for the disputed psychological, physiotherapy, and chronic pain assessments and treatments, finding them reasonable and necessary.

The applicant's claim for an award under Regulation 664 was dismissed because the insurer reasonably relied on its assessors' reports.

The applicant sought entitlement to a non-earner benefit, various medical and rehabilitation benefits, and the cost of assessments following a motor vehicle accident.

The Licence Appeal Tribunal found that the applicant did not suffer a complete inability to carry on a normal life, as he continued to engage in many pre-accident activities and was employed at the time of the accident.

The Tribunal also dismissed the claims for physiotherapy, a functional ultrasound, a chronic pain assessment, and a cognitive assessment, finding them not reasonable and necessary given the soft-tissue nature of the injuries.

The respondent was ordered to pay $460.00 for the outstanding cost of a psychological assessment, but claims for an award and interest were dismissed.

The applicant sought statutory accident benefits for two chiropractic treatment plans totaling $8,320.00 following a motor vehicle accident.

The insurer denied the claims, arguing the treatments were not reasonable and necessary.

The Licence Appeal Tribunal found that the applicant predominantly suffered psychological injuries rather than the claimed neurological and concussion-related injuries.

Relying on the insurer's medical examinations, the Tribunal concluded the disputed treatment plans were not reasonable and necessary.

The application was dismissed.

The applicant sought statutory accident benefits for two chiropractic treatment plans totaling $8,320, claiming she suffered post-concussion syndrome and a WAD 3 injury from a motor vehicle accident.

The insurer denied the benefits.

The Licence Appeal Tribunal dismissed the application, finding the treatment plans were not reasonable and necessary.

The Tribunal preferred the insurer's medical examinations, which found no neurological signs or concussion related to the accident, over the applicant's medical reports, which lacked objective testing and were temporally removed from the treatment plans.