Angela Bertolo

The applicant sought a non-earner benefit, interest, and an award under s. 10 of Reg. 664 following a motor vehicle accident.

The Tribunal applied the Heath test and found the applicant failed to prove a complete inability to carry on a normal life, noting his pre-accident baseline involved minimal activity due to prior health issues and there was substantially little change post-accident.

The Tribunal placed little weight on the applicant's physiotherapist certificate as it lacked detail and included psychological diagnoses outside the practitioner's scope.

The application was dismissed in its entirety.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the respondent's determination that his injuries fell within the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG based on a pre-existing neck fracture, chronic pain, and psychological impairment, and also claimed entitlement to a non-earner benefit and various treatment plans.

The Tribunal found that the applicant failed to provide compelling medical evidence that his pre-existing condition prevented maximal recovery within the MIG, and lacked objective evidence of accident-related chronic pain or psychological impairment.

Relying on the respondent's independent medical examinations, the Tribunal concluded the applicant's injuries were predominantly minor and that he did not suffer a complete inability to carry on a normal life.

The application was dismissed in its entirety.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including income replacement benefits (IRB), attendant care benefits (ACB), and various treatment plans.

The Licence Appeal Tribunal found the applicant was entitled to an IRB for the pre-104 week period, as his accident-related low back pain caused a substantial inability to perform the essential tasks of his employment as an electrician.

However, the Tribunal denied the post-104 week IRB, finding the applicant failed to prove a complete inability to perform less physically demanding work for which he was reasonably suited.

The claim for ACB was dismissed because the applicant provided no evidence that the services were incurred.

The Tribunal approved treatment plans for an in-home attendant care assessment and physical therapy, but denied plans for an occupational therapy assessment and vestibular physiotherapy due to a lack of evidence connecting the symptoms to the accident.

The applicant was awarded interest on overdue benefits but denied a special award.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to a non-earner benefit and medical benefits outside the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that the applicant failed to establish a complete inability to carry on a normal life, as medical evidence demonstrated she could independently perform most activities of daily living and had returned to part-time work.

Furthermore, the applicant did not provide sufficient evidence that a pre-existing lumbosacral spine pathology precluded her maximal recovery within the MIG.

The application was dismissed, and the disputed treatment plans were denied as the MIG funding limit was exhausted.

The applicant sought a non-earner benefit, an award, interest, and costs following a motor vehicle accident.

The respondent denied the benefits, arguing that the applicant's inability to carry on a normal life was due to significant pre-existing physical and psychological conditions, not the accident.

The Tribunal found that the applicant failed to demonstrate a complete inability to carry on a normal life as a result of the accident, noting that his pre-accident conditions had already rendered him unable to work and limited his activities of daily living.

The Tribunal accepted the respondent's insurer's examination reports, which concluded the applicant could still engage in his pre-accident activities.

The claims for a non-earner benefit, an award, interest, and costs were dismissed.

The applicant sought attendant care benefits following a motor vehicle accident.

The respondent paid a portion of the claimed expenses but denied the remainder, arguing they were not incurred.

The Tribunal preferred the respondent's occupational therapy assessments, finding the applicant's condition had improved and she did not require the level of care claimed, particularly for night-time emergencies.

The Tribunal concluded the applicant was not entitled to any attendant care benefits beyond what the respondent had already paid, as the additional expenses did not meet the definition of an 'incurred expense' under section 3(7)(e) of the Schedule and could not be deemed incurred.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits from her insurer, Wawanesa.

The Licence Appeal Tribunal found that the applicant sustained a catastrophic impairment due to marked impairments in adaptation and concentration, persistence, and pace, stemming from somatic symptom disorder and major depressive disorder.

The Tribunal also found the applicant entitled to both pre-104 and post-104 income replacement benefits, as her physical and psychological impairments prevented her from working as a personal support worker or in any suitable employment.

Several treatment plans were deemed payable because Wawanesa failed to provide proper medical and other reasons for denial in its notices, violating s. 38(8) of the Schedule.

Finally, the Tribunal ordered a 30% special award under Regulation 664, finding that Wawanesa unreasonably withheld benefits by blindly following its assessors' reports without considering the totality of the medical evidence or continuously adjusting the file.

The applicant was injured in a motor vehicle accident and sought payment for an occupational therapy assessment and treatment plan.

The insurer denied the plans and raised a late defence of double payment at the hearing.

The arbitrator rejected the late defence as trial by ambush and found no actual double payment occurred.

The arbitrator concluded the treatment plans were reasonable and necessary, noting the insurer's assessor admitted her recommendation might have differed had she received all relevant information.

The arbitrator ordered the insurer to pay for the plans, plus interest at 2% per month compounded monthly, and a special award of $5,500 for unreasonably withholding payment.