Dr. A. Rubenstein

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to income replacement benefits (IRBs), attendant care benefits (ACBs), and various medical and rehabilitation benefits.

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

The Tribunal found that the applicant's right wrist pathology pre-dated the accident and was not exacerbated by it, and rejected the applicant's claim of an accident-related psychological injury.

Consequently, the Tribunal held that the applicant sustained a minor injury subject to the $3,500 funding limit, disentitling him to the disputed treatment plans and ACBs.

The Tribunal also dismissed the claim for IRBs, finding insufficient medical evidence to demonstrate a substantial inability to perform the essential tasks of his employment.

Claims for interest and an award were also dismissed.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits for a psychological assessment, pre-screening, and psychological treatment.

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

The applicant argued that the respondent's denial notices were procedurally defective under s. 38(8) of the Schedule.

The Tribunal found that the respondent's denial notices were sufficient and timely.

The Tribunal concluded that the applicant failed to meet his burden of proving that his injuries warranted removal from the MIG or that the proposed treatment plans were reasonable and necessary.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, arguing her injuries fell outside the Minor Injury Guideline (MIG) due to chronic pain and psychological impairments.

The Tribunal found that the applicant's injuries were predominantly minor and subject to the $3,500 MIG limit.

Relying on the respondent's expert assessments, which included validity testing indicating symptom magnification, the Tribunal concluded the applicant did not suffer from a psychological impairment or chronic pain syndrome.

The Tribunal approved two physiotherapy treatment plans and prescription expenses as reasonable and necessary within the MIG limit, but denied a third physiotherapy plan, a psychological assessment, and a chronic pain assessment.

Claims for an award for unreasonable delay were dismissed, though interest was awarded on the approved benefits.

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

The respondent denied several treatment plans and assessments, and the applicant applied to the Licence Appeal Tribunal for dispute resolution.

The Tribunal found that the applicant's claims for the treatment plans and assessments were statute-barred, as the application was filed more than two years after the respondent's clear and straightforward denials, and there were no reasonable grounds to extend the limitation period.

Furthermore, relying on the uncontradicted reports of the respondent's medical assessors, the Tribunal concluded that the applicant's injuries fell within the Minor Injury Guideline (MIG).

Because the applicant had already exhausted the $3,500 MIG limit, the claim for additional medication expenses was dismissed.

The applicant sought statutory accident benefits for a psychological examination and treatment following a motor vehicle accident.

The respondent insurer denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) based on an insurer's examination.

The Licence Appeal Tribunal found the applicant suffered a psychological impairment outside the MIG, preferring the evidence of the applicant's psychologist over the insurer's expert.

The Tribunal ordered the respondent to pay for the psychological examination and treatment, plus interest, but denied the applicant's claim for a special award for unreasonably delayed payments.