6 total
Application for accident benefits dismissed as injuries fell within the exhausted Minor Injury Guideline limit.
The applicant sought statutory accident benefits following a motor vehicle accident.
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 had been exhausted.
The applicant argued for removal from the MIG due to chronic pain and psychological impairments.
The Tribunal found that the applicant failed to establish a functional impairment related to chronic pain and preferred the respondent's psychological assessment over the applicant's pre-screening report.
The Tribunal concluded the injuries were minor, and since the MIG limit was exhausted, the disputed treatment plans were not payable.
Applicant failed to prove chronic pain or psychological impairment to escape the Minor Injury Guideline.
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 impairment.
The Licence Appeal Tribunal found that the applicant's physical injuries were soft tissue in nature and did not result in functional impairment consistent with chronic pain syndrome.
The Tribunal also preferred the respondent's psychological assessment, which found no evidence of psychological impairment, over the applicant's assessment.
Consequently, the applicant was not removed from the MIG, and the claims for disputed treatment plans, interest, and a section 10 award were dismissed.
Application for accident benefits beyond the Minor Injury Guideline dismissed for lack of compelling medical evidence.
The applicant sought statutory accident benefits for physiotherapy services beyond the $3,500 Minor Injury Guideline (MIG) limit following a motor vehicle accident.
The applicant argued for removal from the MIG based on chronic pain, psychological impairment, and pre-existing conditions.
The Tribunal found insufficient evidence of psychological impairment, chronic pain with functional impairment, or that a pre-existing condition precluded recovery within the MIG.
The Tribunal concluded the applicant's injuries were predominantly minor and dismissed the claims for further physiotherapy and interest.
Chronic pain removed the claim from the MIG, but post-104-week IRBs were denied.
The applicant sought statutory accident benefits following a motor vehicle accident, including income replacement benefits, medical benefits, transportation expenses, an assessment expense, interest, and a special award.
The arbitrator found that credible psychological and orthopedic evidence established chronic pain and related psychological sequelae, taking the claim outside the Minor Injury Guideline and supporting entitlement to the disputed physiotherapy treatment plans.
Applying the Schedule's pre-104-week test, the arbitrator held that the applicant had a substantial inability to perform the essential tasks of his pre-accident employment and was entitled to weekly income replacement benefits for that period only.
The post-104-week claim failed because the evidence did not prove a complete inability to engage in any suitable employment.
Transportation and interest were awarded, the in-home assessment expense and special award were denied, and expenses were left to further determination if necessary.
Appeal of accident benefits arbitration dismissed; appellant failed to prove income or medical necessity.
The appellant appealed an arbitrator's decision dismissing claims for income replacement benefits, medical benefits, and a special award following a motor vehicle accident.
The Director's Delegate found no error of law, noting that the appellant failed to prove any qualifying income for the income replacement benefits and that uncontradicted expert evidence supported the denial of the medical benefits.
The appeal was dismissed, and the appellant was ordered to pay $2,800 in appeal expenses to the insurer.
Accident benefits claim dismissed; applicant failed to prove entitlement to income replacement or medical benefits.
The applicant sought accident benefits following a motor vehicle accident, claiming entitlement to medical benefits and income replacement benefits.
The insurer denied the claims, arguing the applicant was self-employed with no net profits and that her injuries did not warrant further treatment.
The arbitrator found the applicant lacked credibility and accepted the insurer's expert evidence that her physical injuries had plateaued and her psychological issues were unrelated to the accident.
The arbitrator also determined the applicant was self-employed and had no profits, resulting in an income replacement benefit calculation of zero.
The application was dismissed, and the insurer was awarded its expenses.
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