Dr. Frederic Langer

The applicant sought dispute resolution at the Licence Appeal Tribunal after the respondent insurer denied four treatment plans following a motor vehicle accident.

The adjudicator denied the request for an orthopaedic assessment, finding it was based solely on self-reported injuries without objective medical evidence.

Two chiropractic treatment plans were approved as reasonable and necessary because they included appropriate active and passive modalities consistent with the applicant's injuries.

A third chiropractic plan was denied due to a lack of substantive benefit and failure to address other barriers to recovery.

The applicant's claim for a special award under s. 10 of Regulation 664 was dismissed, but interest was awarded on the approved benefits.

The applicant was injured in a motor vehicle accident and sought various medical and rehabilitation benefits, which the respondent insurer denied on the basis that the injuries fell within the Minor Injury Guideline (MIG).

The adjudicator found that the applicant's psychological impairments (adjustment disorder and specific phobia) removed him from the MIG.

The adjudicator ordered the respondent to pay for several chiropractic and physiotherapy treatment plans, finding them reasonable and necessary, and noting the insurer's failure to comply with the 10-day notice requirement under s. 38(8) of the Schedule for some plans.

Claims for a driving re-integration assessment and a chronic pain assessment were dismissed as not reasonable and necessary.

The applicant was awarded interest on overdue payments, but both parties' claims for costs under Rule 19.1 were dismissed.

The applicant sought income replacement benefits (IRBs) and the cost of an orthopaedic assessment following a motor vehicle accident.

The insurer denied the benefits based on insurer examinations and surveillance video, arguing the applicant did not suffer a substantial inability to perform his pre-accident employment as a truck driver assistant and that his injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant's physical and psychological impairments, combined with the heavy physical demands of his pre-accident employment, entitled him to IRBs.

The Tribunal also found the orthopaedic assessment was reasonable and necessary as the applicant's injuries fell outside the MIG.

Both parties' requests for costs were denied.