3 total
Application for statutory accident benefits dismissed; applicant failed to prove entitlement to IRBs and treatment plans.
The applicant sought statutory accident benefits following a motor vehicle accident, including an income replacement benefit (IRB) and two treatment plans for devices and nutritional counseling.
The Tribunal found the applicant was not entitled to IRBs as he returned to full-time work for three months post-accident and failed to prove a substantial inability to perform the essential tasks of his employment.
The treatment plans were also denied as the applicant did not demonstrate they were reasonable and necessary, with the Tribunal preferring the insurer's medical examination which concluded the injuries were minor.
The Tribunal also found the insurer's denial notices complied with section 38 of the Schedule.
The application was dismissed.
Application for physiotherapy treatment plan dismissed due to insufficient medical evidence supporting its necessity.
The applicant sought $1,977.05 for a physiotherapy treatment plan following a motor vehicle accident.
The respondent denied the plan.
The Tribunal found that the applicant failed to meet her burden of proving the treatment was reasonable and necessary, as she did not provide sufficient specific medical evidence linking her ongoing symptoms to the proposed treatment.
The Tribunal preferred the respondent's orthopedic assessment, which concluded the applicant had reached maximal medical improvement.
Application for accident benefits dismissed as injuries fell within the Minor Injury Guideline.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent insurer denied the claims on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Licence Appeal Tribunal found that the medical evidence, including clinical notes from treating physicians and diagnostic imaging, supported a finding of minor soft tissue injuries.
The Tribunal afforded little weight to the applicant's chronic pain specialist's report, noting it lacked objective testing and was contradicted by other medical records.
The application was dismissed as the injuries were subject to the MIG.
No co-appearing lawyers found.
No judges found.