Cody Eriksen

The applicant requested reconsideration of a Licence Appeal Tribunal decision that found she was subject to the Minor Injury Guideline (MIG) and not entitled to a non-earner benefit or disputed treatment plans.

The applicant argued the Tribunal made errors of law and fact, breached procedural fairness, and that new evidence was available.

The Vice-Chair dismissed the arguments regarding errors of law and procedural fairness, finding the original adjudicator properly applied the test for removal from the MIG and correctly assessed the evidence.

However, the Vice-Chair granted the reconsideration request in part based on new evidence—a section 44 physiatry report and an Explanation of Benefits—that the applicant received after the original decision was released.

The Vice-Chair ordered a written rehearing before a different adjudicator limited to the issues of the MIG, disputed treatment plans, and interest.

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

The insurer denied several treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

As a preliminary issue, the insurer argued the applicant was statute-barred from disputing a chiropractic treatment plan due to the two-year limitation period.

The Tribunal found the insurer's initial denial notice was defective under the Smith criteria, meaning the limitation period did not begin until a valid notice was later provided; thus, the claim was not statute-barred.

On the merits, the Tribunal held the applicant failed to prove her psychological impairments or chronic pain warranted removal from the MIG.

However, because the insurer failed to provide a valid denial notice within 10 business days for the first chiropractic treatment plan, it was required under s. 38(11) of the Schedule to pay for services incurred during the period of non-compliance.

All other treatment plans were denied, and the claim for a s. 10 award was dismissed.

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

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

The Tribunal found the applicant suffered an accident-related psychological impairment, warranting removal from the MIG.

The Tribunal approved a $2,200 psychological assessment as reasonable and necessary.

However, claims for a $6,447.13 psychological counselling plan and a $3,770.16 physiotherapy plan were dismissed due to insufficient evidence of how treatment goals would be met and a documented lack of therapeutic effectiveness, respectively.

Interest was awarded on the approved assessment plan.

The applicant sought statutory accident benefits following a 2022 motor vehicle accident.

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

The applicant argued that pre-existing chronic pain and psychological impairments from a 2009 accident warranted removal from the MIG.

The Tribunal found the applicant failed to provide compelling medical evidence that her pre-existing conditions prevented maximal recovery within the MIG limit, preferring the respondent's psychiatric assessment over the applicant's psychological report.

The Tribunal also dismissed the applicant's claim for a non-earner benefit due to the failure to submit a completed disability certificate within the 104-week entitlement period.

The application was dismissed in its entirety.