4 total
Application for non-earner and medical benefits dismissed as applicant failed to prove complete inability.
The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit, funding for a functional cognitive assessment, and psychological services.
The Tribunal dismissed the application.
Applying the Heath test, the adjudicator found the applicant did not suffer a complete inability to carry on a normal life, as medical evidence showed she remained independent in self-care and could perform light housekeeping, with her knee pain likely stemming from pre-existing arthritis.
The treatment plans were deemed not reasonable and necessary based on respondent medical examinations indicating her neurological and psychological issues had largely resolved or did not require the proposed assessments.
A claim for an award under s. 10 of Regulation 664 was also dismissed as the insurer's denials were reasonably based on medical evidence.
Application for accident benefits dismissed; applicant failed to prove injuries warranted removal from the Minor Injury Guideline.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant argued for removal from the MIG based on psychological injuries and a pre-existing anxiety condition.
The Tribunal found the applicant failed to establish on a balance of probabilities that he suffered from accident-related psychological injuries warranting removal, giving little weight to the applicant's psychological and chiropractic evidence.
The Tribunal also found insufficient medical evidence that a pre-existing condition precluded his recovery within the MIG.
The application was dismissed.
Application for accident benefits dismissed; applicant failed to prove injuries warranted removal from Minor Injury Guideline.
The Tribunal found that the applicant failed to prove on a balance of probabilities that she suffered from chronic pain or a psychological impairment warranting removal from the MIG.
The Tribunal preferred the respondent's psychological assessment over the applicant's and noted a lack of ongoing accident-related complaints in the clinical records.
The application for disputed treatment plans and interest was dismissed.
Accident benefits for brain injury denied due to intervening fall; physical therapy plans approved.
The respondent denied benefits, arguing that the applicant's traumatic brain injury was caused by an intervening event—a fall from an examination table during medical treatment months after the accident.
The Tribunal agreed, finding the fall broke the chain of causation.
Consequently, the claim for a non-earner benefit and assessments related to the brain injury were dismissed.
However, the Tribunal found that treatment plans for chiropractic, physiotherapy, and aqua therapy services related to the accident injuries were reasonable and necessary, and ordered their payment with interest.
No co-appearing lawyers found.
No judges found.