3 total
Application for accident benefits dismissed; shoulder tear falls within Minor Injury Guideline and IRB test unmet.
The applicant sought statutory accident benefits following a motor vehicle accident.
The insurer denied the claims, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and that he was no longer disabled from working as a restaurant manager.
The Tribunal found that the applicant's partial thickness shoulder tear constituted a minor injury under the MIG, and there was no evidence his age precluded recovery within the guideline limits.
The Tribunal also dismissed the claim for income replacement benefits, finding the applicant failed to demonstrate a substantial inability to perform the essential tasks of his employment as a restaurant manager.
Claims for a physiotherapy treatment plan, interest, and a section 10 award were consequently dismissed.
Application for accident benefits dismissed as injuries fell within the Minor Injury Guideline limit.
The applicant was injured in a rear-end motor vehicle accident and sought statutory accident benefits for various treatment and assessment plans.
The respondent insurer denied the plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and its $3,500 funding limit.
The applicant argued he suffered from pre-existing impairments, psychological injuries, and chronic pain that removed him from the MIG.
The Tribunal found no evidence that pre-existing conditions precluded recovery, rejected the applicant's psychological expert evidence as contradicted by the applicant's own self-reports, and found insufficient evidence of chronic pain.
The Tribunal concluded the applicant sustained a minor injury and dismissed the application for the disputed benefits and interest.
Application for chiropractic benefits dismissed as applicant failed to prove treatment was reasonable and necessary.
The applicant was injured in a motor vehicle accident and sought medical benefits for chiropractic treatment under the Statutory Accident Benefits Schedule.
The respondent insurer initially denied the benefits under the Minor Injury Guideline, but later conceded the applicant's injuries were non-minor based on a psychological assessment.
The applicant argued that pre-existing lower back pain and chronic pain syndrome necessitated further chiropractic care.
The adjudicator found that the applicant failed to provide objective medical evidence to support the treatment plans, noting that her own treating physicians recommended physiotherapy rather than chiropractic treatment.
The application for medical benefits, interest, and costs was dismissed.
No co-appearing lawyers found.
No judges found.