Dr. Deborah Cowman

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) and that the applicant failed to attend required insurer examinations under s. 44 of the Schedule.

The Tribunal found the applicant was barred from proceeding with two treatment plans due to his unexcused failure to attend the scheduled insurer examinations.

Furthermore, the Tribunal concluded the applicant's injuries were predominantly minor, as there was insufficient medical evidence of chronic pain or psychological impairment to warrant removal from the MIG.

Consequently, the remaining treatment plan was denied, and claims for interest and a s. 10 award were dismissed.

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

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

The Tribunal found that the applicant's physical injuries were predominantly minor and that he failed to prove any pre-existing condition, psychological impairment, or chronic pain with functional impairment that would warrant removal from the MIG.

As the MIG funding limit was exhausted, the disputed treatment plans were not payable.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to physical rehabilitation and a psychological assessment outside the Minor Injury Guideline (MIG).

The applicant argued that she suffered from a psychological impairment and chronic pain with functional impairment.

The Tribunal found that the applicant failed to meet the burden of proof for either condition, noting her continued ability to work, attend university, and participate in sports post-accident.

Applying the AMA Guides criteria for chronic pain, the Tribunal concluded the applicant did not meet the threshold.

The claims for benefits, interest, and an award were dismissed.

The respondent's request for costs was also dismissed, as the applicant's conduct did not rise to the level of bad faith.

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

The applicant claimed her shoulder injury, psychological impairments, and chronic pain warranted removal from the MIG.

The Tribunal found that the shoulder injury was likely a pre-existing condition related to her employment as a personal support worker and was not caused by the accident.

Furthermore, the applicant failed to provide compelling medical evidence of an accident-related psychological impairment or functional limitations due to chronic pain.

The Tribunal concluded the applicant's injuries were subject to the MIG and dismissed the claims for additional medical benefits, examination expenses, interest, and an award.

The applicant sought statutory accident benefits following a rear-end motor vehicle accident.

The respondent denied various treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) limit of $3,500, which had been exhausted.

The Tribunal found that the applicant failed to meet his onus to prove his physical or psychological injuries warranted removal from the MIG.

The adjudicator preferred the respondent's insurer examination reports over the applicant's assessors, noting significant inconsistencies in the applicant's evidence, particularly his failure to report any accident-related complaints to his family doctor for over two years.

The application was dismissed.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including caregiver, housekeeping, and medical benefits, as well as the cost of a psychological assessment.

The insurer denied the claims on procedural grounds (late application) and substantive grounds.

The arbitrator held that the insurer could not rely on the late application because it failed to clearly warn the applicant of the consequences of non-compliance.

Substantively, the arbitrator dismissed the claims for caregiver and housekeeping benefits, finding the applicant was not the primary caregiver and did not suffer a substantial inability to perform housekeeping.

The claim for chiropractic treatment was also dismissed as not reasonable and necessary.

However, the arbitrator ordered the insurer to pay for the proposed psychological assessment, finding it was reasonably required based on the information available to the requesting psychologist.

The claim for a special award was dismissed.

The applicant was involved in three motor vehicle accidents in 2001 and sought income replacement benefits beyond October 6, 2002, claiming he was unable to return to his pre-accident job due to chronic pain and psychological problems.

The insurer terminated benefits based on multiple disability assessments concluding he was capable of working.

The arbitrator found that while the accidents contributed to his complaints, the applicant failed to prove he suffered a substantial inability to perform the essential tasks of his pre-accident employment.

The arbitrator preferred the evidence of the disability assessors over the applicant's treating physicians and experts, noting weaknesses in the latter's opinions and the fact that the applicant had successfully held other jobs post-accident.

The application for ongoing benefits and a special award was dismissed.

The applicant, a caregiver injured in a motor vehicle accident, sought loss of earning capacity benefits (LECBs).

The parties agreed her residual earning capacity was zero, but disputed her pre-accident earning capacity (PEC).

The insurer argued her PEC was zero due to pre-accident cognitive and physical limitations, relying on a psychologist's assessment.

The arbitrator rejected the psychologist's opinion as unreliable and accepted the applicant's vocational expert, finding her PEC should be based on a gross annual income of $18,000 as an unskilled industrial worker.

The arbitrator dismissed the applicant's claims for retroactive attendant care benefits due to lack of evidence on quantum, and for the cost of an actuarial report obtained for settlement purposes.

The applicant sought statutory accident benefits for psychological treatment, physiotherapy, housekeeping, and the cost of assessments following a motor vehicle accident.

The arbitrator dismissed all claims, finding that the applicant suffered from significant credibility issues, having failed to disclose a prior accident and pre-existing conditions to medical assessors.

The arbitrator relied on the findings of the insurer's examiners and the Med/Rehab DAC assessors, who concluded that further treatment was not reasonable or necessary.

The claims for housekeeping and assessment costs were also dismissed for lack of evidence and medical referral.

Due to the applicant's lack of success and her representative's problematic conduct during the hearing, the parties were ordered to bear their own arbitration expenses.

The applicant was injured in a motor vehicle accident and received caregiver benefits.

The insurer terminated these benefits and made a loss of earning capacity (LEC) offer of zero.

The applicant claimed a higher LEC benefit, transportation expenses, housekeeping expenses, and a special award.

The arbitrator found that the applicant was not entitled to a LEC offer because she did not have the functional capacity to earn income at the time of the accident due to severe pre-existing psychiatric problems.

The arbitrator awarded the claimed transportation and housekeeping expenses, but denied the special award.