Dr. Bruce Cook

The applicant sought statutory accident benefits following a 2017 motor vehicle accident, including treatment plans for catastrophic impairment assessments, an attendant care assessment, and chiropractic services.

The insurer denied the benefits.

The Tribunal found the applicant's self-reporting to be highly inconsistent and unreliable, contradicting medical records and surveillance evidence.

The Tribunal preferred the insurer's medical examinations, which found no ongoing physical or psychological impairments attributable to the accident.

The application was dismissed, and no benefits or interest were awarded.

The applicant sought a non-earner benefit (NEB) and a medical benefit for chiropractic services following a motor vehicle accident.

The insurer denied the NEB on the basis that the applicant did not suffer a complete inability to carry on a normal life, and denied the medical benefit as not reasonable and necessary.

The adjudicator found that the applicant was not entitled to the NEB, as she had successfully returned to school and secured full-time employment post-accident, demonstrating an ability to engage in substantially all of her pre-accident activities.

However, the adjudicator found the proposed chiropractic treatment plan to be reasonable and necessary for pain relief, noting that the applicant's symptoms had improved with similar past treatment.

The medical benefit was granted with interest.

The applicant sought statutory accident benefits following a motor vehicle accident, including income replacement benefits (IRBs) and various medical and rehabilitation benefits.

The respondent insurer denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant failed to demonstrate on a balance of probabilities that her physical or psychological injuries warranted removal from the MIG.

The Tribunal preferred the evidence of the respondent's section 44 assessors over the applicant's treating practitioners and psychological report.

As the MIG limits were exhausted, the disputed treatment plans were deemed not reasonable and necessary.

The claim for IRBs was also dismissed as the applicant failed to establish a substantial inability to perform the essential tasks of her employment.

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

The respondent determined the applicant's injuries fell within the Minor Injury Guideline (MIG) and denied further treatment plans and income replacement benefits (IRB) after the $3,500 limit was exhausted.

The Tribunal found that the applicant failed to prove on a balance of probabilities that he suffered from chronic pain or psychological injuries caused by the accident that would remove him from the MIG, noting he withheld information about a subsequent shooting incident from his assessors.

The Tribunal also found the applicant did not suffer a substantial inability to perform the essential tasks of his employment.

The application was dismissed.

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

The respondent denied several treatment plans for chiropractic and psychological services on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit had been exhausted.

The adjudicator found that the respondent complied with the notice requirements under s. 38(8) of the Schedule.

On the substantive issue, the adjudicator concluded that the applicant's physical injuries were soft tissue in nature and his psychological impairments did not remove him from the MIG.

The adjudicator also found that the applicant did not meet the criteria for chronic pain.

As the applicant's injuries were predominantly minor and the MIG limit was exhausted, the application for further medical benefits was dismissed.

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

The Licence Appeal Tribunal found that the insurer failed to provide adequate medical reasons in its notices denying certain treatment plans under s. 38(8) of the Schedule, entitling the applicant to incurred costs until proper notice is given.

The Tribunal also found three chiropractic treatment plans and one psychological treatment plan to be reasonable and necessary.

However, a second psychological treatment plan, a chronic pain assessment, and a cognitive assessment were deemed not reasonable and necessary.

The applicant's claim for an award under Regulation 664 was dismissed.

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

The insurer terminated IRBs after 104 weeks, arguing the applicant did not meet the test for complete inability to work.

The Tribunal found that while the applicant failed to prove physical impairment, he successfully established that his psychological impairments, caused by the accident, rendered him completely unable to engage in any employment for which he was reasonably suited.

The Tribunal awarded IRBs from November 15, 2015, ongoing, with interest.

The respondent's request for costs was denied.

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

The Licence Appeal Tribunal found that while the applicant's physical injuries were minor, her psychological impairments, including depression and anxiety, placed her outside the MIG.

The Tribunal denied five treatment plans for facility-based physical rehabilitation, finding the applicant had reached maximal recovery for her physical injuries.

However, the Tribunal approved the cost of a social work assessment up to the $2,000 statutory limit, finding it reasonable and necessary to address her ongoing psychological impairments.

Both parties' requests for costs were denied.