Dr. Friesen

The applicant sought medical and rehabilitation benefits under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The disputed benefits included treatment plans for psychometric testing, a neuro-psychological examination, and a neuro-psychological intake interview recommended by her psychologist.

The adjudicator found that the applicant failed to prove the treatment plans were reasonable and necessary.

The adjudicator preferred the evidence of the respondent's multidisciplinary assessors, who concluded there was no ongoing accident-related brain injury or cognitive impairment.

The application was dismissed and no interest was payable.

The applicant, a pedestrian struck by a vehicle, sought statutory accident benefits for attendant care, assistive devices, and psychological and physiological treatment.

The insurer denied the claims.

The Licence Appeal Tribunal found that the applicant was entitled to the psychological treatment plan, as the evidence demonstrated that his pre-existing psychological issues were exacerbated by the accident.

However, the claims for attendant care and assistive devices were dismissed because the applicant failed to prove they were reasonable and necessary, and failed to provide evidence that the expenses were incurred.

A claim for a special award was also dismissed, as the insurer's denials were not improper.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including medical benefits and Income Replacement Benefits (IRBs).

The insurer denied several treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG), and stopped IRBs based on insurer examinations.

The Licence Appeal Tribunal found that the applicant's median nerve neuropathy removed him from the MIG.

The Tribunal approved one treatment plan for physiotherapy and braces but denied others for lack of supporting evidence.

The Tribunal also ordered the reinstatement of IRBs up to the two-year anniversary of the accident, finding the applicant was substantially unable to perform his pre-accident employment as a warehouse worker and driver, and awarded interest on overdue payments.

The applicant sought an income replacement benefit and funding for a psychological treatment plan following a motor vehicle accident.

The Licence Appeal Tribunal found that the applicant was not entitled to an income replacement benefit because her physical limitations were caused by pre-existing knee osteoarthritis, not the accident, and her psychological impairments did not cause a substantial inability to perform her employment tasks.

The Tribunal also found that the balance of the psychological treatment plan was not reasonable and necessary, as the rates charged were excessive and not in accordance with the Guideline.

However, the Tribunal held that the insurer had waived the signature requirement for the treatment plan by partially approving it.

The applicant was awarded interest on the partially approved psychotherapy sessions but was denied a special award under O. Reg. 664.