Dr. Millard

The applicant sought statutory accident benefits following a motor vehicle accident, including psychological services, custom orthotic shoes, a functional cognitive assessment, and a driving reintegration assessment.

The adjudicator dismissed the application, finding that the applicant failed to prove the treatment and assessment plans were reasonable and necessary.

The adjudicator relied on insurer's examination reports which indicated the applicant's psychological symptoms had largely resolved and did not warrant further treatment or assessment.

Claims for an award and interest were also dismissed.

The applicant sought medical and rehabilitation benefits, including chronic pain treatment, an MRI, and orthopaedic and neurological assessments, following a 2016 motor vehicle accident.

The insurer denied the benefits.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to establish that the treatments and assessments were reasonable and necessary.

The Tribunal preferred the objective evidence of the insurer's assessors over the applicant's chronic pain specialist, noting the applicant did not meet the AMA Guides criteria for chronic pain syndrome.

The applicant was injured in a motor vehicle accident and sought medical and rehabilitation benefits for assistive devices and laser foot therapy under the Statutory Accident Benefits Schedule.

The respondent denied the benefits, arguing they were not reasonable and necessary and were related to pre-existing conditions rather than the accident.

The Tribunal applied the 'but for' test for causation and found that the applicant failed to prove the requested treatments and devices were required due to accident-related impairments.

The Tribunal concluded the applicant's mobility and balance issues were pre-existing, and the foot numbness was related to prior chemotherapy.

The application was dismissed.

The applicant was injured in a motor vehicle accident and sought medical and rehabilitation benefits, which the insurer denied on the basis that her injuries fell within the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that while the applicant's physical injuries were predominantly minor, she demonstrated on a balance of probabilities that she suffers from chronic pain syndrome with a psychological component, warranting removal from the MIG.

The Tribunal ordered payment for one physiotherapy treatment plan, psychological assessment and treatment, and prescription expenses, finding them reasonable and necessary to address her chronic pain.

The remaining treatment plans and assessments were denied as redundant or unnecessary, and the claim for a special award was dismissed as the insurer had a genuine dispute.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for a chronic pain program and assessment.

The respondent insurer denied the benefits, arguing the injuries fell within the $3,500 Minor Injury Guideline (MIG) cap and that the chronic pain was not caused by the accident.

The Tribunal found that the applicant suffered from pre-existing chronic pain that was exacerbated by the accident, preventing maximal medical recovery within the MIG limits.

Relying on medical evidence, including reports from the respondent's own independent examiners, the Tribunal concluded the applicant's injuries were not predominantly minor.

The applicant was removed from the MIG and awarded the disputed treatment plans and assessment, along with interest on overdue benefits.

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

The respondent denied funding for physiotherapy and psychological treatment plans 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 did not suffer from a psychological impairment or chronic pain syndrome as a result of the accident that would warrant removal from the MIG.

The applicant's appeal was dismissed.

The applicant sought payment for various medical and assessment benefits following a motor vehicle accident.

The respondent insurer denied the benefits on the basis that the applicant's injuries were predominantly minor and subject to the $3,500 limit under the Minor Injury Guideline (MIG).

The Tribunal found that the applicant's injuries were soft tissue in nature and fell within the MIG.

The Tribunal preferred the evidence of the insurer's examiners over the applicant's assessors, noting the former reviewed comprehensive medical records.

Furthermore, the applicant failed to provide compelling evidence of a pre-existing medical condition that would warrant an exception to the MIG cap.

The application was dismissed.