Dr. Hefford

The applicant sought accident benefits following a motor vehicle accident, claiming removal from the Minor Injury Guideline (MIG) due to a concussion and psychological impairment, as well as entitlement to income replacement benefits (IRBs) and various treatment plans.

The Tribunal found the medical evidence did not support a concussion or psychological impairment, keeping the applicant within the MIG and denying the treatment plans.

Although the applicant failed to meet the substantive test for IRBs, the Tribunal awarded IRBs from February 27, 2023, to April 14, 2023, because the insurer failed to respond to the disability certificate within the required 10 business days under s. 36(4) of the Schedule.

Claims for an award were dismissed.

The applicant sought statutory accident benefits following a 2017 motor vehicle accident.

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

The Tribunal found that the applicant failed to prove her psychological and chronic pain impairments were caused by the 2017 accident, noting a failure by her medical assessors to account for a prior 2014 accident.

The application for treatment plans, an award for unreasonable delay, and interest was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to psychological and chronic pain assessments outside the Minor Injury Guideline (MIG).

The respondent denied the benefits, arguing the injuries were predominantly minor.

The Tribunal found the applicant failed to prove on a balance of probabilities that she suffered from chronic pain with a functional impairment or an accident-related psychological condition, noting compelling evidence of malingering from the respondent's psychological expert.

The application was dismissed, and claims for the assessments, a special award, and interest were denied.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits from the respondent insurer.

Following a reconsideration decision that removed the applicant from the Minor Injury Guideline, a rehearing was held to determine entitlement to disputed treatment plans and assessments.

The Tribunal found the applicant was entitled to three physiotherapy treatment plans and a psychological assessment, as the medical evidence, including reports from an orthopaedic surgeon and the respondent's own psychological assessor, established they were reasonable and necessary.

Claims for an attendant care assessment and a TMJ assessment were dismissed due to insufficient medical evidence linking the conditions to the accident or demonstrating necessity.

The applicant's request for a special award was denied as the respondent had not unreasonably withheld or delayed payments.

The applicant sought non-earner benefits following a motor vehicle accident, claiming physical and psychological impairments prevented her from carrying on a normal life.

The adjudicator applied the Heath framework and found that while the applicant experienced some changes in her post-accident life, she could still perform many of her pre-accident activities, including childcare and self-care, without significant restrictions.

The application for non-earner benefits, along with claims for an award and interest, was dismissed.