10 total
Application for accident benefits dismissed; applicant failed to prove injuries warranted removal from the Minor Injury Guideline.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied various chiropractic and psychological treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant failed to prove on a balance of probabilities that he suffered from a pre-existing condition, a psychological impairment, or chronic pain that would warrant removal from the MIG.
The Tribunal preferred the respondent's psychological and physical assessments, noting a lack of psychological symptoms in the treating practitioners' records and no evidence of functional impairment.
The application for the disputed treatment plans, interest, and an award was dismissed.
Application for accident benefits dismissed; applicant's injuries fall within the Minor Injury Guideline and IRB repayment ordered.
The respondent denied the benefits, arguing the injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found the applicant's injuries were predominantly minor and she did not establish a pre-existing condition, chronic pain, or psychological impairment to warrant removal from the MIG.
The claims for a chronic pain assessment, psychological assessment, and Income Replacement Benefits (IRBs) were dismissed.
The Tribunal also ordered the applicant to repay $1,227.49 in overpaid IRBs to the respondent, as she had returned to work without notifying the insurer.
Application for accident benefits dismissed; applicant failed to prove inability to work or need for treatment.
The self-represented applicant sought statutory accident benefits following a July 2021 motor vehicle accident, including income replacement benefits (IRBs), a physiotherapy treatment plan, and medication expenses.
The Licence Appeal Tribunal dismissed the application.
The Tribunal found the applicant was not entitled to pre-104 week IRBs as he continued to work in various roles after the accident and failed to provide medical evidence of a substantial inability to perform his essential tasks.
Consequently, he did not qualify for post-104 week IRBs.
The Tribunal also denied the physiotherapy treatment plan due to a lack of corroborating medical evidence demonstrating it was reasonable and necessary.
Finally, the Tribunal found the claimed medication expenses had already been paid in full by the respondent.
Application for non-earner benefit dismissed as applicant did not suffer complete inability to carry on normal life.
The applicant sought a non-earner benefit (NEB) following a motor vehicle accident, which the respondent insurer denied.
The applicant argued the denial notice was deficient and that she met the disability test based on psychological assessments.
The Tribunal found the denial notice compliant as it clearly referenced the independent medical assessors' conclusions.
Relying on the insurer's psychological assessment, the Tribunal concluded the applicant did not suffer a complete inability to carry on a normal life, as she continued to perform personal care, household chores, and caregiving duties.
The application for the NEB, an award, and interest was dismissed.
Application for accident benefits dismissed; applicant failed to prove entitlement to MIG removal or IRBs.
The applicant sought statutory accident benefits following a motor vehicle accident, including removal from the Minor Injury Guideline (MIG), income replacement benefits (IRBs), and approval of treatment plans.
The Licence Appeal Tribunal found that the applicant failed to prove his injuries, including alleged chronic pain and psychological impairments, warranted removal from the MIG.
As the $3,500 MIG limit was exhausted, the disputed treatment plans were not payable.
The Tribunal also dismissed the claim for IRBs, finding insufficient evidence that the applicant suffered a substantial inability to perform the essential tasks of his pre-accident employment as a warehouse worker.
Claims for interest and an award were consequently dismissed.
Applicant remains in Minor Injury Guideline; failed to prove chronic pain or pre-existing conditions precluded recovery.
The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant sought removal from the MIG based on a partial shoulder tear, pre-existing conditions, chronic pain syndrome, and psychological issues.
The Tribunal found that the applicant failed to provide compelling medical evidence to support removal from the MIG on any of these grounds.
The applicant's expert reports were given less weight due to non-compliance with procedural rules and lack of functional impairment evidence.
The Tribunal concluded the applicant remains within the MIG and is not entitled to the disputed treatment plans.
Accident benefits denied; applicant barred by criminal conviction and injuries fell within Minor Injury Guideline.
The Tribunal found the applicant was barred from receiving a non-earner benefit under s. 31(1)(d)(i) of the Schedule because she was convicted of a criminal offence on the day of the accident.
The Tribunal also held that the applicant's injuries were predominantly minor and subject to the $3,500 Minor Injury Guideline limit, as the medical evidence showed her psychological conditions pre-dated the accident and were not exacerbated by it.
The application for treatment plans and an award was dismissed.
Application for accident benefits dismissed; injuries fell within the Minor Injury Guideline and non-earner benefits denied.
The Tribunal found that the applicant's physical injuries were minor soft-tissue strains and that he failed to establish any accident-related psychological impairments warranting removal from the MIG.
Because the $3,500 MIG limit was exhausted, the disputed treatment plans were not payable.
The Tribunal also dismissed the claim for non-earner benefits, finding the applicant failed to prove a complete inability to carry on a normal life, and denied the request for a special award.
Applicant denied income replacement benefits due to credibility issues but granted funding for physiatry and psychological assessments.
The applicant sought statutory accident benefits following a motor vehicle accident, including income replacement benefits (IRBs) and funding for various medical assessments and treatments.
The Licence Appeal Tribunal found that the applicant was not entitled to pre-104 or post-104 week IRBs, as she failed to prove a substantial inability to perform her pre-accident employment tasks or a complete inability to engage in any suitable employment, largely due to credibility issues and lack of effort during assessments.
The Tribunal also denied funding for chiropractic services and a functional abilities assessment.
However, the Tribunal granted funding for a physiatry assessment and a psychological examination to further explore the applicant's chronic pain and psychological symptoms, along with interest on these overdue amounts.
Application for income replacement and medical benefits dismissed as applicant failed to prove complete inability to work.
The applicant was struck by a vehicle in a parking lot and sought income replacement benefits and medical benefits for chiropractic services.
The adjudicator found that the applicant did not suffer a complete inability to engage in employment after the first 104 weeks, relying on independent medical examinations which concluded she could perform the essential tasks of her employment.
The adjudicator also found that the proposed chiropractic treatments were not reasonable and necessary.
All claims, including those for interest and a special award, were dismissed.
No co-appearing lawyers found.
No judges found.