3 total
Accident benefits claim dismissed; expert evidence established lack of objective impairment and non-credible symptom reporting.
The applicant sought statutory accident benefits following a sideswipe motor vehicle collision, claiming entitlement to an income replacement benefit, various medical and rehabilitation treatment plans, and a special award.
The respondent denied the benefits on the basis that the applicant did not suffer a substantial inability to perform the essential tasks of her employment and that the proposed treatments were not reasonable or necessary.
The Tribunal dismissed the application in its entirety, preferring the evidence of the respondent's experts who found no objective pathology, noted significant self-limiting and non-credible behaviour on validity testing, and concluded the collision forces were insufficient to cause the alleged mild traumatic brain injury.
The claim for a special award was also dismissed as the respondent's adjusting was found to be reasonable.
Insurer ordered to pay for assessments due to defective denial notices; other treatment plans denied.
The applicant sought statutory accident benefits following a motor vehicle accident, which was followed by a second accident less than two months later.
The insurer denied several treatment plans for physiotherapy, psychotherapy, and various assessments.
The Tribunal found that the applicant's physical injuries were caused by the first accident, but she failed to prove her psychological injuries were caused by it.
The Tribunal ordered the insurer to pay for an impairment assessment and a neurological assessment because its denial notices failed to comply with the medical reasons requirement under s. 38(8) of the Schedule.
The remaining claims for treatment plans, an award for unreasonable delay, and costs were dismissed.
Psychotherapy treatment plan approved based on insurer's own assessment; chronic pain assessment denied.
The applicant sought statutory accident benefits following a motor vehicle accident, specifically funding for psychotherapy services and a chronic pain assessment.
The adjudicator found the psychotherapy treatment plan reasonable and necessary, relying on the respondent's own psychological assessment which indicated the applicant needed further treatment to reach maximal recovery.
However, the claim for a chronic pain assessment was dismissed, as the applicant had returned to full-time work, had large gaps in treatment, and the respondent's medical examinations concluded further assessment was unnecessary.
The applicant was awarded the psychotherapy benefits with interest.
No co-appearing lawyers found.
No judges found.