11 total
Application for post-104-week income replacement benefits and treatment plans dismissed due to insufficient evidence of inability to work.
The applicant sought income replacement benefits (IRBs) post-104 weeks, as well as payment for chiropractic services and catastrophic assessments following a motor vehicle accident.
The Licence Appeal Tribunal dismissed the application, finding the applicant failed to prove a complete inability to engage in suitable employment, relying on surveillance evidence and independent medical examinations showing the applicant could perform employment-type activities.
The Tribunal also found the proposed treatment plans and assessments were not reasonable and necessary, as they were duplicative of previously completed programs or lacked justification.
Claims for interest and an award were consequently dismissed.
Application for accident benefits dismissed; applicant failed to prove chronic pain or psychological impairment warranting MIG removal.
The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to physiotherapy and psychological treatment plans outside the $3,500 Minor Injury Guideline (MIG) limit.
The applicant argued that chronic pain and psychological impairments warranted removal from the MIG.
The Tribunal found insufficient medical evidence to establish chronic pain with functional impairment or a psychological impairment caused by the accident, preferring the respondent's insurer's examinations.
As the applicant remained within the MIG and the limits were exhausted, the disputed treatment plans and interest were denied.
Application for psychological assessment dismissed as self-reported symptoms were contradicted by surveillance evidence.
The applicant sought entitlement to a $2,200 psychological assessment, a special award, and interest following a motor vehicle accident.
The Licence Appeal Tribunal dismissed the application, finding the treatment plan was not reasonable and necessary.
The Tribunal rejected the applicant's psychological evidence, noting it relied on self-reporting that was contradicted by surveillance footage showing the applicant driving frequently and engaging in various activities.
The Tribunal accepted the respondent's insurer examination, which found no psychological symptoms warranting further investigation.
Application for accident benefits dismissed as injuries fell within the Minor Injury Guideline limit.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent determined the applicant's injuries fell within the Minor Injury Guideline (MIG) and denied several treatment plans that proposed treatment outside the MIG limit.
The Tribunal found that the applicant failed to prove her injuries were not predominantly minor, as medical evidence indicated only soft-tissue injuries and unrelated health issues.
Because the applicant remained within the MIG and the disputed treatment plans exceeded the MIG limit, the application for the treatment plans and interest was dismissed.
Non-earner benefit denied for failure to meet the Heath test; psychological treatment plan approved.
The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to a non-earner benefit (NEB) and a partially denied treatment plan for psychological services.
The Licence Appeal Tribunal found that the applicant did not meet the test for a complete inability to carry on a normal life, as medical evidence and an in-home assessment showed he could continue his pre-accident activities, albeit at a slower pace.
The NEB claim was dismissed.
However, the Tribunal approved the disputed treatment plan for psychological services, preferring the applicant's expert evidence which thoroughly detailed the need for 1.5-hour therapy sessions.
The applicant was awarded the cost of the treatment plan with interest, but his claim for an award under s. 10 of Regulation 664 was dismissed due to lack of evidence of unreasonable delay by the insurer.
Applicant's psychological impairments removed him from the Minor Injury Guideline; disputed treatment plans and interest awarded.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits.
The respondent insurer denied claims for psychological and physical treatment, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Licence Appeal Tribunal found that the applicant suffered from accident-related psychological impairments, including major depressive disorder and PTSD, which removed him from the MIG.
The Tribunal preferred the evidence of the applicant's psychologists over the respondent's assessor, noting the respondent's assessor's conclusions contradicted his own test results.
The Tribunal ordered the respondent to pay for the disputed psychological assessments and chiropractic services, along with interest on overdue payments.
Applicant removed from Minor Injury Guideline due to psychological impairment; partial treatment benefits awarded.
The respondent denied several treatment plans and assessments on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant sustained a psychological impairment as a result of the accident, entitling her to treatment outside the MIG framework.
The Tribunal partially approved a treatment plan for massage therapy and fully approved a psychological assessment, but denied the remaining claims for physical therapy and various other assessments due to lack of evidence of reasonableness and necessity.
The respondent's request for costs was also denied.
Applicant awarded medical and rehabilitation benefits but denied income replacement and attendant care benefits.
The Licence Appeal Tribunal found that the applicant's right wrist impairment pre-dated the accident and was not caused by it.
The Tribunal granted the applicant's claims for a knee brace, chiropractic and physiotherapy treatment, a psychological assessment, and a chronic pain assessment, finding them reasonable and necessary.
However, the Tribunal dismissed the claims for income replacement benefits, finding the applicant did not suffer a substantial inability to perform his sedentary pre-accident employment as a debt collector.
The claim for attendant care benefits was also dismissed as the expenses were not incurred and the applicant was found to be independent with personal care tasks.
A police officer convicted of breach of trust received a suspended sentence due to exceptional mitigating circumstances including severe alcohol addiction.
A police officer with 14 years of service pleaded guilty to breach of trust and careless storage of a firearm.
The Crown sought 12 months imprisonment plus probation, emphasizing denunciation and deterrence.
The court found exceptional mitigating circumstances including severe alcohol addiction, emotional abuse by a partner, unresolved grief from a parent's death, and a sleep disorder.
The officer had undergone significant rehabilitation post-arrest, including residential treatment, weekly AA attendance, and psychotherapy.
Despite the serious nature of breaching a position of trust, the court imposed a suspended sentence with three years probation and 150 hours community service, recognizing that the officer's conduct was entirely out of character and driven by addiction rather than corruption or venality.
Application dismissed; employee failed to participate in reasonable graduated return to work accommodation.
The applicant alleged that his employer discriminated against him on the basis of disability by terminating his employment.
After a period of medical leave, the employer proposed a graduated return to work based on an independent medical assessment.
The applicant refused to return to work, insisting he needed to be one hundred percent recovered.
The Tribunal dismissed the application, finding that the employer had proposed a reasonable accommodation and that the applicant had breached his duty to facilitate the accommodation process by refusing to participate.
Applicant awarded ongoing income replacement benefits after 104 weeks due to chronic pain and psychological impairments.
The applicant was injured in a motor vehicle accident while riding his bicycle.
The insurer paid income replacement benefits for 104 weeks but terminated them, arguing the applicant did not meet the more stringent test of complete inability to engage in suitable employment.
The arbitrator found the applicant, who was functionally illiterate in English and had a history of heavy physical labour, suffered from chronic pain and psychological impairments caused by the accident.
The arbitrator rejected the insurer's expert evidence that the applicant was malingering, finding instead that he was completely disabled from working.
The applicant was awarded ongoing income replacement benefits.
However, his claim for a multidisciplinary pain management program was dismissed as he failed to prove it was reasonable and necessary, given a previous similar program had not yielded further recovery.