25 total
Application for income replacement benefits dismissed due to inconsistent medical evidence and unreliable self-reporting.
The applicant sought income replacement benefits (IRBs) following a motor vehicle accident, claiming he suffered from chronic pain that prevented him from working as a carpenter apprentice.
The adjudicator dismissed the application, finding the applicant's evidence and his expert's chronic pain assessment unreliable due to inconsistencies with the medical records, including evidence of prior injuries, altercations, and drug use.
The adjudicator preferred the respondent's orthopaedic and functional assessments, concluding the applicant failed to prove a substantial inability to perform his pre-accident employment for the pre-104 week period, or a complete inability to engage in suitable employment for the post-104 week period.
Claims for an award and interest were also dismissed.
Statutory accident benefits denied; applicant failed to prove injuries fell outside the Minor Injury Guideline.
The applicant was injured in a motor vehicle accident and sought various statutory accident benefits, which the respondent insurer denied on the basis that her injuries fell within the Minor Injury Guideline (MIG).
The applicant argued she should be removed from the MIG due to pre-existing hypothyroidism and psychological impairments.
The Tribunal found that the applicant failed to provide compelling evidence that her pre-existing condition prevented her from achieving maximal recovery within the MIG cap, preferring the respondent's psychological assessment over the applicant's.
All claims for benefits were dismissed, and the applicant was ordered to pay $200 in costs for repeatedly filing evidence late.
Application for accident benefits dismissed; applicant failed to establish pre-existing condition to escape Minor Injury Guideline.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied a treatment plan for physiotherapy on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant argued she should be removed from the MIG due to a pre-existing condition of scoliosis and chronic pain.
The Tribunal found that the applicant failed to establish that her pre-existing condition was documented prior to the accident or would prevent maximal recovery within the MIG limit.
The Tribunal also found insufficient evidence of chronic pain.
The application was dismissed.
Application for accident benefits beyond the Minor Injury Guideline dismissed due to applicant's high functionality.
The central issue was whether the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant's medical experts opined that he suffered from chronic pain and psychological impairments outside the MIG.
However, the adjudicator preferred the insurer's medical examination and the applicant's own statements, which confirmed he was working full-time, attending school, and maintaining his social life.
The adjudicator concluded the injuries were predominantly minor and dismissed the application for benefits beyond the MIG cap, as well as claims for interest and a special award.
Minor's accident benefits claim not statute-barred, but dismissed on merits as injuries fell within MIG.
The applicant, who was a minor at the time of the motor vehicle accident, sought a non-earner benefit and medical benefits beyond the Minor Injury Guideline (MIG) limit.
The respondent argued the claim for the non-earner benefit was statute-barred under the two-year limitation period.
The Tribunal held that the limitation period was suspended under s. 6 of the Limitations Act because the applicant was a minor and her mother's assistance in applying for benefits did not make her a litigation guardian.
However, on the merits, the Tribunal found the applicant failed to prove a complete inability to carry on a normal life, noting inconsistencies in her self-reporting and preferring the respondent's insurer examinations.
The Tribunal also concluded the applicant's injuries fell within the MIG, as there was insufficient evidence of psychological impairment or chronic pain to warrant removal.
All claims for benefits and costs were dismissed.
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