Bruno Rositano

The applicant sought a post-104-week income replacement benefit (IRB) following a motor vehicle accident, which the respondent insurer denied.

The Tribunal found that the applicant suffers a complete inability to engage in any employment for which she is reasonably suited by education, training, or experience, primarily due to chronic pain syndrome and psychological impairments.

The Tribunal preferred the evidence of the applicant's expert assessors over the respondent's assessors, noting that the alternate employment roles proposed by the respondent were not comparable in status or wages.

The applicant was awarded the IRB and interest on overdue payments, but her claim for a special award under section 10 of Regulation 664 was dismissed as the insurer's conduct was not found to be unreasonable or vexatious.

The applicant sought various statutory accident benefits following a motor vehicle accident, including attendant care benefits, assistive devices, medical cannabis, and a psychovocational assessment.

The Tribunal denied the attendant care benefits because the applicant failed to prove the expenses were incurred after she dismissed her personal support worker.

Claims for a new mattress and medical cannabis were also dismissed for lack of medical evidence establishing them as reasonable and necessary.

However, the Tribunal granted the request for a psychovocational assessment, finding that the respondent's assessors had not adequately evaluated the applicant's ability to perform the heavy physical and mental demands of her pre-accident employment as a personal support worker.

The Tribunal also approved a prescription for Metformin, accepting that the applicant's accident-related inactivity exacerbated her pre-existing diabetes.

The claim for a special award was dismissed.

The self-represented applicant sought statutory accident benefits following a July 2021 motor vehicle accident, including income replacement benefits (IRBs), a physiotherapy treatment plan, and medication expenses.

The Licence Appeal Tribunal dismissed the application.

The Tribunal found the applicant was not entitled to pre-104 week IRBs as he continued to work in various roles after the accident and failed to provide medical evidence of a substantial inability to perform his essential tasks.

Consequently, he did not qualify for post-104 week IRBs.

The Tribunal also denied the physiotherapy treatment plan due to a lack of corroborating medical evidence demonstrating it was reasonable and necessary.

Finally, the Tribunal found the claimed medication expenses had already been paid in full by the respondent.

The applicant sought an income replacement benefit (IRB) following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding the applicant procedurally disentitled due to his failure to comply with section 33 of the Schedule and document production orders regarding his financial and employment records.

Furthermore, the Tribunal found the applicant failed to substantively establish a substantial inability to perform the essential tasks of his employment within 104 weeks of the accident, or a complete inability to engage in suitable employment thereafter.

Claims for an award and interest were also dismissed.

The applicant sought statutory accident benefits following a 2017 motor vehicle accident, claiming catastrophic impairment, income replacement benefits (IRB), and various medical and rehabilitation benefits.

The Licence Appeal Tribunal found the applicant was not catastrophically impaired, as she did not demonstrate Marked or Class 4 impairments in three of four functional domains, relying partly on surveillance evidence showing her ability to socialize and complete tasks.

Consequently, her claim for attendant care benefits was dismissed.

However, the Tribunal granted her claim for a post-104-week IRB, finding her severe chronic pain and heavy medication use rendered her completely unable to engage in suitable employment.

Several treatment plans, including for medical marijuana and lidocaine injections, were approved as reasonable and necessary for pain relief, while others were denied.

The claim for an award for unreasonably withheld benefits was dismissed.