Dr. Benfayed

The applicant sought statutory accident benefits for two chiropractic treatment plans following a rear-end motor vehicle accident.

The insurer denied the plans.

At the Licence Appeal Tribunal, the adjudicator found that the applicant failed to prove the treatments were reasonable and necessary.

The medical evidence, including clinical notes and records, did not support an ongoing physical impairment requiring the proposed treatment.

The adjudicator accepted the insurer's orthopaedic assessment that the applicant's soft tissue injuries had resolved.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the insurer's determination that her injuries fell within the Minor Injury Guideline (MIG) and claiming entitlement to income replacement benefits (IRBs) and various medical benefits.

The adjudicator found that the insurer complied with the notice requirements under s. 38(8) of the Schedule.

Relying on insurer examinations and surveillance evidence that contradicted the applicant's self-reports of impairment, the adjudicator concluded the applicant sustained predominantly minor injuries and did not suffer from chronic pain caused by the accident.

As the $3,500 MIG limit was exhausted, the medical benefits were denied.

The claim for IRBs was also dismissed because the applicant failed to establish a substantial inability to perform the essential tasks of her employment, having returned to work for five weeks immediately after the accident.