6 total
Application for accident benefits dismissed as barred by res judicata; new medical reports did not constitute fresh evidence.
The applicant sought statutory accident benefits following a motor vehicle accident.
In a prior 2024 decision, the Tribunal determined the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant filed a second application seeking removal from the MIG based on new treatment plans and medical reports.
The respondent raised the preliminary issue of res judicata.
The Tribunal found that the three preconditions for issue estoppel were met and that the new medical reports did not constitute fresh, previously unavailable evidence that would impeach the original result.
The application was dismissed as barred by res judicata.
Application for income replacement and medical benefits dismissed as applicant failed to prove substantial inability.
The applicant sought statutory accident benefits following a motor vehicle accident, including an income replacement benefit (IRB), medical and rehabilitation benefits for physiotherapy and psychological services, and an award for unreasonable delay.
The Licence Appeal Tribunal dismissed the application in its entirety.
The Tribunal found the applicant failed to prove a substantial inability to perform the essential tasks of her employment, preferring the respondent's expert evidence over the applicant's experts.
The Tribunal also found the applicant failed to prove the disputed treatment plans were reasonable and necessary.
Application for accident benefits dismissed; injuries found to fall within the Minor Injury Guideline.
The applicant sought statutory accident benefits following a motor vehicle accident, claiming her injuries warranted removal from the Minor Injury Guideline (MIG) due to chronic pain and psychological impairments.
The Tribunal found the applicant failed to meet her burden of proof, noting the lack of contemporaneous medical records and the limited probative value of her assessor's report, which relied heavily on self-reporting.
The Tribunal concluded the applicant's injuries were predominantly minor and subject to the $3,500 MIG limit, dismissing her claims for a chronic pain assessment, chiropractic services, and interest.
Application for functional abilities evaluation dismissed; applicant failed to prove assessment was reasonable and necessary.
The applicant sought statutory accident benefits following a motor vehicle accident, specifically requesting funding for a functional abilities evaluation (FAE).
The applicant also attempted to add a claim for psychotherapy treatment late in the proceedings, which the Tribunal denied due to procedural unfairness.
On the substantive issue, the Tribunal found the applicant failed to prove the FAE was reasonable and necessary.
The Tribunal placed little weight on the applicant's medical reports, which relied heavily on self-reporting, and preferred the respondent's multidisciplinary assessments, which found no functional impairment and noted the applicant's self-limiting behavior during testing.
The application was dismissed, and the respondent's request for costs was denied.
Tribunal grants various medical benefits and a 25 percent special award for unreasonably withheld psychological treatment.
The applicant was injured in a motor vehicle accident and sought various medical benefits under the Statutory Accident Benefits Schedule, which were denied by the respondent insurer.
The applicant applied to the Licence Appeal Tribunal to dispute the denials of treatment plans for acupuncture, physiotherapy, chiropractic treatment, chronic pain programs, a functional abilities evaluation, and disability certificates.
The Tribunal found that the applicant proved the reasonableness and necessity of the acupuncture, physiotherapy, chiropractic treatment, functional abilities evaluation, and the psychological components of the chronic pain programs.
The physical components of the chronic pain programs and the disability certificates were denied.
Furthermore, the Tribunal awarded the applicant a 25 percent special award under O. Reg. 664 for the insurer's unreasonable delay and withholding of specific benefits, noting the insurer failed to properly consider all available medical information, including its own assessors' reports.
Claim for non-earner benefits dismissed as applicant failed to prove complete inability to carry on a normal life.
The applicant sought non-earner benefits following a motor vehicle accident.
The respondent argued the applicant was barred from claiming non-earner benefits because he was eligible for income replacement benefits.
The Tribunal found the applicant was not barred, as the respondent failed to provide an election form and the applicant did not ultimately qualify for income replacement benefits.
However, the Tribunal dismissed the claim for non-earner benefits, finding the applicant's medical evidence failed to establish a complete inability to carry on a normal life under the Heath test.
No linked lawyers found.
No linked judges found.