Dr. Gwardjan

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG based on psychological impairments and chronic pain.

The Tribunal found that the applicant failed to meet the evidentiary burden to prove a psychological impairment or chronic pain condition that would warrant treatment outside the MIG limits.

The application for disputed treatment plans and assessments was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming his injuries warranted removal from the Minor Injury Guideline (MIG) due to a lens displacement injury and pre-existing physical and psychological conditions.

The Tribunal found insufficient evidence linking the eye injury to the accident and concluded that the applicant's pre-existing conditions did not prevent him from achieving maximal recovery under the MIG.

As the applicant's impairments were predominantly minor, he was subject to the $3,500 funding limit, and his claims for treatment plans exceeding this limit, along with claims for interest and an award, were dismissed.

The applicant was injured in a motor vehicle accident and sought post-104 weeks income replacement benefits (IRBs), arguing she suffered a complete inability to engage in suitable employment.

The Tribunal preferred the respondent's expert evidence, finding the applicant retained the functional capacity for sedentary work and did not meet the complete inability test.

The Tribunal also held that the respondent correctly deducted the applicant's maternity leave Employment Insurance benefits from her pre-104 weeks IRBs, as they constitute gross employment income under the Schedule.

Finally, the Tribunal dismissed the claim for a special award, finding the respondent's handling of the claim and temporary stoppages of benefits pending further medical information were not unreasonable.

The applicant was injured in a motor vehicle accident and received income replacement benefits until the respondent terminated them based on insurer examinations.

The applicant sought reinstatement of the benefits and approval for a physiatry assessment.

The Tribunal found that the insurer's medical reports did not support termination and that the applicant continued to suffer a substantial inability to perform the essential tasks of his pre-accident employment as a realtor and motel manager.

The Tribunal awarded income replacement benefits up to the 104-week mark, approved the physiatry assessment, and awarded interest, but denied the applicant's request for costs and a special award.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent insurer denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant suffered from chronic pain and psychological impairments as a result of the accident, removing him from the MIG.

The Tribunal ordered the respondent to pay for several treatment plans for physical rehabilitation, a social work assessment, and a disability certificate, finding them reasonable and necessary.

However, the claim for a functional abilities evaluation was dismissed as the applicant had returned to work.

Interest was awarded on the overdue benefits.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent denied a treatment plan for physiotherapy on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit had been exhausted.

The applicant argued she should be removed from the MIG due to pre-existing conditions, chronic pain, and psychological impairment.

The Tribunal found insufficient evidence of a documented pre-existing condition that would prevent maximal recovery.

Furthermore, the Tribunal preferred the respondent's multi-disciplinary independent medical examinations, which concluded the applicant's physical and psychological injuries were predominantly minor and did not cause significant functional impairment.

The application was dismissed.

The Applicant was catastrophically injured in a motor vehicle accident, sustaining a traumatic brain injury and chronic pain.

He applied for statutory accident benefits, including non-earner, attendant care, and housekeeping benefits, which the Insurer denied or underpaid.

The Arbitrator found that the Applicant suffered a complete inability to lead a normal life and awarded non-earner benefits.

The Arbitrator also deemed past attendant care and housekeeping expenses to have been incurred under s. 3(8) of the Schedule, finding that the Insurer unreasonably withheld benefits by failing to advise the impecunious and functionally illiterate Applicant that it would pay for professional services.

However, the Arbitrator declined to order a special award, finding the Insurer's conduct was not sufficiently egregious.