Dr. M. Ko

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

The respondent denied funding for several treatment and assessment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant claimed he developed psychological injuries and chronic pain syndrome warranting treatment outside the MIG.

The Tribunal found insufficient evidence of a psychological injury or chronic pain condition, preferring the respondent's insurer examination reports over the applicant's chronic pain assessment.

The Tribunal concluded the applicant sustained a minor injury, the disputed plans were not reasonable and necessary as they fell outside the MIG, and no award or interest was payable.

The application was dismissed.

The applicant sought medical, income replacement, and attendant care benefits following a rear-end motor vehicle accident.

The insurer denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that the applicant sustained predominantly soft tissue injuries, which are defined as minor injuries under the Schedule.

Consequently, the applicant was not entitled to the disputed medical benefits or attendant care benefits.

The claim for income replacement benefits was also dismissed, as the applicant failed to prove a substantial inability to perform his pre-accident employment tasks, and his tax returns showed his income increased after the accident.

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

The respondent denied certain benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant contended that chronic pain and psychological impairments removed him from the MIG.

The Tribunal found that the applicant failed to provide sufficient objective medical evidence to establish chronic pain or a psychological impairment caused by the accident.

The Tribunal preferred the respondent's expert evidence, which found no significant physical or psychological impairments beyond minor sprains and strains.

As the applicant's injuries were predominantly minor and the $3,500 MIG limit was exhausted, the disputed treatment and assessment plans were not payable.

The applicant sought statutory accident benefits following a 2017 motor vehicle accident, including treatment plans for catastrophic impairment assessments, an attendant care assessment, and chiropractic services.

The insurer denied the benefits.

The Tribunal found the applicant's self-reporting to be highly inconsistent and unreliable, contradicting medical records and surveillance evidence.

The Tribunal preferred the insurer's medical examinations, which found no ongoing physical or psychological impairments attributable to the accident.

The application was dismissed, and no benefits or interest were awarded.

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 statutory accident benefits following a 2018 motor vehicle accident.

The respondent insurer denied funding for chiropractic treatment, the unapproved balance of a psychological treatment plan, and an orthopedic assessment.

The Licence Appeal Tribunal found that the applicant's ongoing pain complaints and functional impairments, supported by medical records and an orthopedic assessment diagnosing chronic pain syndrome, justified the disputed treatment plans.

The Tribunal ordered the respondent to pay the full amounts for the chiropractic treatment and orthopedic assessment, a partial amount for the psychological treatment plan, and interest on overdue payments.