5 total
Applicant removed from Minor Injury Guideline due to chronic pain and awarded disputed treatment plans.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied several treatment and assessment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant suffered from chronic pain with functional impairments, removing her from the MIG.
The Tribunal ordered the respondent to pay for the disputed physiotherapy, psychological, and chronic pain treatment plans, finding them reasonable and necessary.
The applicant's claim for a special award for unreasonable delay was dismissed, but interest on overdue benefits was granted.
Accident benefits application dismissed; applicant failed to prove injuries warranted removal from the MIG.
The respondent denied various treatment plans and assessments on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant argued she should be removed from the MIG due to psychological impairment and chronic pain.
The Tribunal found the applicant's evidence, including reports from a chiropractor and a psychological assessment, lacked weight and corroboration.
Relying on the respondent's insurer's examinations, the Tribunal concluded the applicant did not suffer a psychological impairment or meet the AMA Guides criteria for chronic pain with functional impairment.
As the applicant remained within the MIG, the disputed treatment plans were not payable, and claims for interest and an award were dismissed.
Application for income replacement benefits dismissed as work stoppage was due to COVID-19, not accident impairments.
The applicant sought income replacement benefits (IRBs) following a 2017 motor vehicle accident.
The respondent initially paid IRBs but terminated them in March 2018 based on insurer's examinations.
The applicant claimed entitlement for two periods: March 2018 to April 2019 (pre-104 weeks) and March 2020 onwards (post-104 weeks).
The Tribunal dismissed the application, finding the applicant failed to prove a substantial inability to perform the essential tasks of his employment for the first period, noting evidence he had returned to work earlier than claimed.
For the post-104-week period, the Tribunal found the applicant stopped working in March 2020 due to COVID-19 concerns rather than a complete inability to engage in employment due to accident-related impairments.
Applicant removed from Minor Injury Guideline due to psychological impairment; partial treatment benefits awarded.
The respondent insurer denied various medical and rehabilitation benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Licence Appeal Tribunal found that the applicant sustained a psychological impairment (moderate depressive episode and adjustment disorder with anxiety) that warranted removal from the MIG.
The Tribunal preferred the evidence of the applicant's psychologist over the insurer's expert.
The Tribunal awarded funding for a psychological assessment, initial chiropractic treatment, and psychological treatment at a reduced hourly rate for unregulated providers.
Subsequent chiropractic treatment plans were denied as the applicant had plateaued in recovery.
Accident benefits claim dismissed as injuries fell within the Minor Injury Guideline cap.
The Applicant claimed statutory accident benefits for medical treatment and examination costs following a motor vehicle accident.
The Insurer denied the claims on the basis that the Applicant's injuries fell within the Minor Injury Guideline (MIG) and she had exhausted the $3,500 cap.
The Applicant argued she suffered psychological impairments and required treatment outside the MIG.
The arbitrator found no objective evidence of psychological impairment or any pre-existing condition that would prevent maximal recovery within the MIG cap.
The arbitrator accepted the Insurer's expert evidence that the Applicant exaggerated her symptoms and that her physical injuries were minor.
The application for benefits was dismissed.
No co-appearing lawyers found.
No judges found.