Dr. Alfonse Marchie

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

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

The Tribunal found the applicant's chronic pain and psychological impairments warranted removal from the MIG.

The Tribunal ordered the respondent to pay for a psychological assessment and occupational therapy treatment, plus interest on overdue payments.

The applicant's request for a special award under s. 10 of Regulation 664 was dismissed, as there was no evidence the respondent unreasonably withheld or delayed payments.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming entitlement to three physiotherapy treatment plans and a psychological assessment.

The Licence Appeal Tribunal found that while the applicant suffered from chronic pain syndrome, she failed to provide specific medical evidence demonstrating that the disputed physiotherapy plans were reasonable and necessary.

The Tribunal also denied the psychological assessment, finding it duplicative of a prior assessment conducted by the respondent's assessor.

Claims for interest, a special award, and costs were consequently dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to income replacement benefits (IRBs), removal from the Minor Injury Guideline (MIG), and funding for psychological and physiotherapy treatment plans.

The Licence Appeal Tribunal found that the applicant failed to prove a substantial inability to perform the essential tasks of her pre-accident employment as a nail specialist, dismissing the IRB claim.

However, based on psychological assessments diagnosing adjustment disorder and anxiety, the Tribunal determined the applicant's injuries fell outside the MIG.

Consequently, the Tribunal approved the $2,200 psychological assessment but denied the $4,115.12 physiotherapy plan, preferring the respondent's physiatrist evidence that further physical treatment was unwarranted.

The applicant sought income replacement benefits (IRBs) following a 2017 motor vehicle accident.

The respondent initially paid IRBs but terminated them in March 2018 based on insurer's examinations.

The applicant claimed entitlement for two periods: March 2018 to April 2019 (pre-104 weeks) and March 2020 onwards (post-104 weeks).

The Tribunal dismissed the application, finding the applicant failed to prove a substantial inability to perform the essential tasks of his employment for the first period, noting evidence he had returned to work earlier than claimed.

For the post-104-week period, the Tribunal found the applicant stopped working in March 2020 due to COVID-19 concerns rather than a complete inability to engage in employment due to accident-related impairments.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming costs for physiotherapy, a physiatry assessment, and a psychological assessment.

The adjudicator found the physiotherapy treatment plan reasonable and necessary as the applicant reported gradual improvement and pain relief.

The physiatry assessment was also approved, supported by medical opinions indicating the applicant suffered from chronic pain syndrome extending beyond the expected recovery period.

However, the claim for a psychological assessment was dismissed because there was insufficient documented evidence of psychological impairments in the family physician's records, and the respondent's psychological assessment finding no impairment was preferred.

Interest was awarded on the overdue payments for the approved benefits.

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

The respondent insurer took the position that the applicant's injuries fell within the Minor Injury Guideline (MIG) and denied several treatment plans.

The applicant argued she should be removed from the MIG due to pre-existing conditions and chronic pain.

The Tribunal found the applicant failed to prove that her pre-existing conditions prevented maximal recovery within the MIG or that her chronic pain adversely affected her well-being and function under the AMA Guides criteria.

However, the Tribunal ordered the respondent to pay for a physiatry assessment because the respondent failed to provide proper medical reasons for its denial, triggering the consequences of s. 38(11) of the Schedule.

The remaining treatment plans were dismissed as they proposed treatment outside the MIG limits.

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

The respondent denied several 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 chronic pain and psychological impairments.

The Tribunal found the applicant's evidence regarding chronic pain to be inconsistent and preferred the respondent's psychological expert over the applicant's.

The Tribunal concluded the applicant's injuries were predominantly minor and she was not removed from the MIG.

As the $3,500 MIG limit was exhausted, the treatment plans were not payable.

The respondent's request for costs was denied.

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.