9 total
Application for accident benefits dismissed; applicant failed to prove injuries warranted removal from Minor Injury Guideline.
The applicant sought statutory accident benefits following a motor vehicle accident, disputing the insurer's determination that his injuries fell within the Minor Injury Guideline (MIG).
The applicant argued he suffered from chronic pain and a psychological injury warranting removal from the MIG.
The Tribunal found the applicant failed to establish functionally disabling pain, noting his active lifestyle and lack of objective medical evidence.
The Tribunal also afforded diminished weight to the applicant's psychological assessment due to its heavy reliance on self-reporting and inconsistency with objective scores.
The application was dismissed, and the applicant was found not entitled to the disputed treatment plans, an award, or interest.
Applicant removed from Minor Injury Guideline due to chronic pain; various treatment plans partially approved.
The applicant sought statutory accident benefits following a motor vehicle accident.
The insurer denied benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found the applicant was removed from the MIG due to accident-related chronic pain that impaired her function, relying on treating practitioner records and the insurer's own physiatry assessments.
The Tribunal awarded partial entitlement to attendant care benefits, but found them not payable as they had not been incurred.
Various treatment plans for occupational therapy, assistive devices, a psychological assessment, and physiotherapy were partially or fully approved as reasonable and necessary.
The applicant's claim for a special award was dismissed due to procedural non-compliance in her submissions.
Accident benefits claim dismissed; impairments fell within Minor Injury Guideline and non-earner test not met.
The respondent denied certain treatment plans and a non-earner benefit, arguing the applicant's impairments fell within the Minor Injury Guideline (MIG).
The adjudicator found that the applicant failed to prove she suffered from chronic pain or a psychological impairment that would remove her from the MIG, preferring the respondent's expert evidence due to the applicant's inconsistent self-reports.
As the $3,500 MIG limit was exhausted, the disputed treatment plans were not payable.
The adjudicator also dismissed the claim for a non-earner benefit, finding the applicant did not suffer a complete inability to carry on a normal life.
Statutory accident benefits application dismissed; injuries found predominantly minor and subject to MIG limits.
The applicant sought statutory accident benefits following a motor vehicle accident, including income replacement benefits (IRBs) and various medical and rehabilitation benefits.
The respondent insurer denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant failed to demonstrate on a balance of probabilities that her physical or psychological injuries warranted removal from the MIG.
The Tribunal preferred the evidence of the respondent's section 44 assessors over the applicant's treating practitioners and psychological report.
As the MIG limits were exhausted, the disputed treatment plans were deemed not reasonable and necessary.
The claim for IRBs was also dismissed as the applicant failed to establish a substantial inability to perform the essential tasks of her employment.
Application for accident benefits dismissed; injuries remained within the Minor Injury Guideline.
The respondent determined the applicant's injuries fell within the Minor Injury Guideline (MIG) and denied further treatment plans and income replacement benefits (IRB) after the $3,500 limit was exhausted.
The Tribunal found that the applicant failed to prove on a balance of probabilities that he suffered from chronic pain or psychological injuries caused by the accident that would remove him from the MIG, noting he withheld information about a subsequent shooting incident from his assessors.
The Tribunal also found the applicant did not suffer a substantial inability to perform the essential tasks of his employment.
The application was dismissed.
The applicant was injured in a motor vehicle accident and sought various medical benefits and costs of examinations from the respondent insurer.
The insurer denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant failed to meet the burden of proving that his physical or psychological impairments warranted removal from the MIG.
The Tribunal also dismissed the claims for the costs of examinations, finding them not reasonable and necessary, and denied the claim for a section 10 award.
Application for accident benefits dismissed as injuries fell within the Minor Injury Guideline limit.
The respondent denied several treatment plans for chiropractic and psychological services on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit had been exhausted.
The adjudicator found that the respondent complied with the notice requirements under s. 38(8) of the Schedule.
On the substantive issue, the adjudicator concluded that the applicant's physical injuries were soft tissue in nature and his psychological impairments did not remove him from the MIG.
The adjudicator also found that the applicant did not meet the criteria for chronic pain.
As the applicant's injuries were predominantly minor and the MIG limit was exhausted, the application for further medical benefits was dismissed.
Application for accident benefits dismissed as injuries fell within the Minor Injury Guideline.
The applicant was injured in a motor vehicle accident and sought medical benefits beyond the $3,500 limit prescribed by the Minor Injury Guideline (MIG).
The applicant argued that his injuries fell outside the MIG due to psychological impairments, chronic pain, and a pre-existing condition.
The adjudicator found the applicant's medical evidence inconsistent, particularly noting the lack of psychological complaints or referrals in his family physician's clinical notes.
The adjudicator concluded that the applicant sustained predominantly minor injuries and was subject to the MIG limit.
The application for further benefits was dismissed, and neither party was awarded costs.
Applicant's claims for additional accident benefits dismissed as injuries fell within the Minor Injury Guideline.
The Applicant was injured in a motor vehicle accident and sought accident benefits from the Insurer.
The Insurer determined that the Applicant's injuries fell within the Minor Injury Guideline (MIG) and paid the maximum $3,500 limit.
The Applicant argued that her pre-existing injuries, chronic pain, and psychological impairments warranted removal from the MIG.
The Arbitrator found that the Applicant failed to provide compelling evidence of a pre-existing condition that would prevent her from achieving maximal recovery within the MIG.
The Arbitrator also found no persuasive evidence of chronic pain or psychological impairment resulting from the accident.
As the Insurer had already paid the maximum amount under the MIG, the Applicant's claims for additional medical benefits and examination costs were dismissed.
No co-appearing lawyers found.
No judges found.