2 total
Application for accident benefits dismissed as proposed chiropractic and psychological treatments were not reasonable and necessary.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits for chiropractic and psychological services.
The respondent insurer denied the treatment plans based on insurer examinations which found no objective physical impairments and concluded that the applicant's psychological symptoms were related to pre-existing behavioural issues rather than the accident.
The adjudicator agreed with the respondent's medical experts, finding that the applicant failed to prove the treatments were reasonable and necessary.
The application was dismissed.
Application for accident benefits dismissed; applicant failed to prove injuries fell outside the Minor Injury Guideline.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied certain medical benefits, arguing the injuries fell within the Minor Injury Guideline (MIG).
The applicant argued that psychological impairments and chronic pain removed him from the MIG.
The Tribunal preferred the respondent's psychological assessment, which utilized validity indices, over the applicant's assessment, which relied primarily on self-reporting.
The Tribunal found the applicant failed to prove his injuries were not predominantly minor, and therefore the disputed medical benefits, interest, and award were not payable.
No co-appearing lawyers found.
No judges found.