2 total
Application for accident benefits dismissed as proposed treatment plans were not proven reasonable and necessary.
The applicant sought payment for three treatment plans (OCF-18s) for chiropractic, massage, and physiotherapy services following a motor vehicle accident.
The Licence Appeal Tribunal found that the applicant failed to prove the treatments were reasonable and necessary, noting a lack of contemporaneous medical records recommending the treatments and preferring the respondent's medical assessments.
The application for benefits and interest was dismissed.
Application for accident benefits dismissed due to unreliable evidence and failure to escape the Minor Injury Guideline.
The applicant sought statutory accident benefits, including income replacement benefits (IRBs) and medical/rehabilitation benefits, following a motor vehicle accident.
The insurer terminated IRBs and denied further treatment plans, arguing the applicant's injuries were minor and did not prevent him from working.
The arbitrator dismissed the application, finding the applicant's evidence regarding his inability to work highly unreliable and contradicted by his employment records and his family doctor's clinical notes.
The arbitrator also held that the applicant's physical and psychological impairments fell within the Minor Injury Guideline (MIG), as there was no compelling evidence from his treating health practitioner that a pre-existing condition would prevent him from achieving maximal recovery within the MIG limits.
No co-appearing lawyers found.
No judges found.