Dr. Lorne Tugg

The applicant sought statutory accident benefits following a motor vehicle accident, including income replacement benefits (IRBs), physiotherapy, psychological treatments, and medication expenses.

The Tribunal found the applicant was disentitled to pre-104 week IRBs due to non-compliance with section 33 of the Schedule for failing to provide self-employment financial records, and did not meet the test for post-104 week IRBs.

The Tribunal approved the physiotherapy treatment plans as reasonable and necessary, but dismissed the claims for the unapproved portions of the psychological treatment plans and the medication expenses.

The claim for an award under section 10 of Regulation 664 was dismissed as the insurer's denials were reasonably informed by independent medical examinations.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the respondent's denial of several treatment plans for physiotherapy, psychological services, and an attendant care assessment, as well as a claim for a special award.

The Tribunal found the applicant was not entitled to the physiotherapy plan or the attendant care assessment due to a lack of objective medical evidence demonstrating functional limitations.

However, the Tribunal granted the outstanding balances for four psychological treatment plans, preferring the treating psychologist's recommendation for 1.5-hour sessions over the insurer's 1-hour approvals.

A subsequent psychological treatment plan was denied based on a psychiatric assessment attributing current symptoms to non-accident-related factors.

The claim for a special award was dismissed as the insurer's conduct was not unreasonable.

The applicant sought entitlement to several treatment and assessment plans (OCF-18s) under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The respondent insurer denied the plans based on insurer's examinations indicating the applicant had reached maximum medical improvement or that her symptoms were related to pre-existing conditions.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to meet her burden of proving the disputed plans were reasonable and necessary.

The Tribunal noted a lack of objective medical evidence supporting the requested treatments and found the applicant's submissions often failed to address the specific goals and costs of the proposed plans.

The applicant sought accident benefits following a motor vehicle accident, claiming entitlement to an income replacement benefit and various treatment plans.

The respondent denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant failed to prove her pre-existing low back pain was exacerbated by the accident or that she sustained a psychological injury.

The Tribunal preferred the respondent's psychiatric assessment over the applicant's psychological report, which contained factual misstatements regarding her pre-accident employment and the timing of her husband's death.

The application was dismissed, as the injuries were predominantly minor and the applicant failed to establish a substantial inability to perform the essential tasks of her employment.

The applicant sought a non-earner benefit following a 2013 motor vehicle accident, claiming it exacerbated her pre-existing psychiatric issues and chronic pain.

The insurer denied the benefit, arguing her activities of daily living had not substantially changed.

The arbitrator found that the applicant's normal life had changed due to a prior 2011 accident and family conflicts, not the 2013 accident.

Despite an aggravation of her chronic pain, she continued to engage in substantially all her pre-accident activities, such as attending workshops, driving, and socializing.

The application was dismissed, and expenses were awarded to the insurer.