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Tribunal denies physiotherapy plan but partially approves psychological treatment plans for accident benefits.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits for physiotherapy and psychological services.
The respondent denied the treatment plans, and the applicant applied to the Licence Appeal Tribunal.
The Tribunal found that the applicant failed to prove the physiotherapy plan was reasonable and necessary, as the medical evidence did not corroborate the need for the proposed treatments and the applicant had reported physiotherapy made her worse.
However, the Tribunal partially approved the psychological treatment plans, finding the requested time for mental health testing and completing the OCF-18 form to be reasonable, while reducing the time claimed for session preparation and notetaking.
The applicant was awarded $274.81 for psychological services plus interest.
Accident benefits claim dismissed; injuries fell within Minor Injury Guideline and non-earner benefit criteria unmet.
The applicant sought statutory accident benefits following a motor vehicle accident, disputing the respondent's determination that his injuries fell within the Minor Injury Guideline (MIG).
The applicant argued he suffered from chronic pain and an adjustment disorder, relying on brief reports from his treating physicians.
The Tribunal preferred the detailed reports of the respondent's medical assessors, finding insufficient evidence of chronic pain or psychological impairment.
The Tribunal concluded the injuries were predominantly minor and subject to the MIG limit.
As the applicant had exhausted the MIG limit, the disputed treatment plans were denied.
The Tribunal also dismissed the claim for a non-earner benefit, finding the applicant returned to full-time work shortly after the accident and did not suffer a complete inability to carry on a normal life.
Income replacement benefits awarded for a limited period; further medical benefits denied as policy limits exhausted.
The applicant was injured in a motor vehicle accident and sought income replacement benefits (IRBs) and medical benefits from his insurer.
The insurer initially paid some benefits but later terminated them, arguing the applicant suffered only minor injuries and was capable of working.
The arbitrator found that the applicant was entitled to IRBs for a limited period from August 2013 to October 2013, as he had returned to work thereafter and failed to prove a complete inability to engage in employment.
The claims for further medical benefits were dismissed because the insurer had already paid the $50,000 policy limit after conceding the applicant's pre-existing condition removed him from the Minor Injury Guideline.
Interest was awarded on benefits that the insurer had delayed paying.
No co-appearing lawyers found.
No judges found.