Dr. J. Wong

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to income replacement benefits (IRBs), a physiotherapy treatment plan, and an in-home assessment.

The Licence Appeal Tribunal found that the applicant failed to prove a substantial inability to perform the essential tasks of her pre-accident employment as a waitress, preferring the respondent's insurer's examination reports over the applicant's medical evidence.

Consequently, the claim for IRBs was denied.

The Tribunal also denied the in-home assessment, noting the applicant reported independence with activities of daily living.

However, the Tribunal approved the physiotherapy treatment plan as reasonable and necessary to address ongoing neck and back pain, and awarded interest on that plan.

The applicant sought statutory accident benefits following a rear-end motor vehicle collision.

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

The applicant argued he should be removed from the MIG due to chronic pain and psychological impairments, relying on expert reports from a physiatrist and a psychiatrist.

The Tribunal found the expert reports unpersuasive as they failed to distinguish pre-existing conditions, relied on an unproven concussion diagnosis, and contradicted the objective medical records of the treating family physician.

The Tribunal concluded the applicant sustained only minor soft tissue injuries and dismissed the application.

The applicant sought statutory accident benefits following a motor vehicle accident, including income replacement benefits (IRBs), medical benefits for chiropractic and psychological treatment, and an award for unreasonable delay.

The Tribunal found the applicant was not entitled to IRBs, as medical evidence and surveillance footage showing the applicant performing heavy lifting for his pre-accident employer contradicted his claim of substantial inability to work.

The claim for chiropractic treatment was dismissed as duplicative of an already approved plan.

However, the Tribunal granted the unapproved portion of the psychological treatment plan, preferring the treating providers' recommendation of 1.5-hour sessions over the insurer's examination assessor's unexplained recommendation of 1.0-hour sessions.

The claim for an award was dismissed, but interest was awarded on the overdue psychological benefit.

The applicant sought a determination of catastrophic impairment and entitlement to attendant care benefits, cost of examinations, interest, and an award following a 2007 motor vehicle accident.

The Licence Appeal Tribunal found the applicant sustained a catastrophic impairment under Criterion 8, specifically a Class 4 Marked impairment in the domain of Activities of Daily Living due to chronic pain and psychological impairments.

The Tribunal awarded attendant care benefits at $507.03 per month for feeding, along with the costs of an occupational therapy situational assessment and an in-home attendant care assessment.

Claims for a triage assessment, an award under Regulation 664, and costs were dismissed.

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

The respondent determined the applicant's injuries fell within the Minor Injury Guideline (MIG) and refused to pay for certain medical benefits beyond the $3,500 funding limit.

The applicant argued that pre-existing chronic low back pain precluded her recovery within the MIG.

The Tribunal found that the applicant's injuries were predominantly minor, noting that clinical records and an independent medical examination showed only soft tissue injuries and no evidence that the pre-existing condition would prolong recovery.

Consequently, the disputed treatment plans were deemed not reasonable and necessary, and the claims for benefits and interest were dismissed.

The applicant was injured in a rear-end motor vehicle collision and sought statutory accident benefits for chiropractic treatment and a physiatry assessment.

The respondent insurer denied the claims on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 funding limit had been exhausted.

The Tribunal found that the applicant's physical injuries, including a partial rotator cuff tear, were minor injuries under the Schedule.

The Tribunal preferred the evidence of the respondent's experts over the applicant's physiatrist, finding no compelling evidence of a pre-existing condition or psychological injury that would preclude recovery within the MIG.

The application was dismissed.

The applicant sought expenses following a successful arbitration for statutory accident benefits.

The parties agreed on most costs but disputed the allowability of three expert reports totaling $4,000.

The arbitrator found that the reports from an exercise physiologist and a physician were necessary for the conduct of the arbitration, as they established the continuity of the applicant's disability and chronic pain syndrome.

The arbitrator awarded the applicant $29,589.48 in total expenses, plus $209.50 for the costs of the expense hearing.

In a dispute over income replacement benefits, the respondent raised a preliminary issue seeking to exclude four sets of documents submitted by the applicant, arguing they breached a prior Tribunal order and disclosure rules.

The adjudicator found no breach of the prior order.

Three documents were served within the filing deadline and were admitted.

The fourth document, an expert report, was served late under Rule 10.

Applying Rule 3.1 to liberally interpret the rules, the adjudicator admitted the expert report as relevant and necessary, curing any prejudice by granting the respondent 30 days to review and respond to it.