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Applicant removed from Minor Injury Guideline due to chronic pain; disputed treatment plans approved.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied several treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found the applicant demonstrated a chronic pain condition with functional impairment, satisfying the AMA Guides criteria, and removed him from the MIG.
The Tribunal approved the disputed treatment plans for chiropractic services, psychological services, and various assessments, finding them reasonable and necessary based on the treating practitioners' records and s. 25 assessments.
The claim for a special award under s. 10 of Reg. 664 was dismissed, as the respondent reasonably relied on its expert reports.
Post-104 week IRBs awarded due to accident-exacerbated shoulder injury; most treatment plans denied for insufficient evidence.
The applicant sought statutory accident benefits following a motor vehicle accident, including post-104 week income replacement benefits (IRBs) and various treatment plans.
The Tribunal found that the applicant suffered a complete inability to engage in any employment for which he was reasonably suited due to a severe shoulder injury requiring surgery, exacerbated by the accident, and awarded IRBs at the optional rate of $1,000 per week.
The Tribunal denied most of the disputed treatment plans for lack of supporting medical evidence, but approved a vocational assessment relevant to the IRB claim.
The request for a special award was dismissed as the insurer's denial was not found to be unreasonable, though interest was awarded on overdue benefits.
Applicant's injuries found to fall within the Minor Injury Guideline; claims for psychological assessment dismissed.
The applicant sought medical and rehabilitation benefits following a motor vehicle accident, arguing his injuries fell outside the Minor Injury Guideline (MIG) due to chronic pain, pre-existing injuries, and psychological issues.
The Licence Appeal Tribunal found that the applicant failed to meet the burden of proving his injuries fell outside the MIG.
The medical evidence did not support a finding of chronic pain under the AMA criteria, nor did it establish a significant psychological impairment or that a pre-existing condition prevented maximal recovery.
Consequently, the claims for a psychological assessment, interest, and a special award were dismissed.
Applicant's injuries fell within the Minor Injury Guideline; claims for medical benefits beyond the $3,500 limit dismissed.
The applicant sought statutory accident benefits following a motor vehicle accident, but the insurer denied further payments on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit had been reached.
The applicant argued that his injuries were not predominantly minor due to psychological impairments, physical injuries including chronic pain, and pre-existing conditions.
The Licence Appeal Tribunal found that the applicant failed to prove on a balance of probabilities that he suffered from a psychological impairment, a non-minor physical injury, or a pre-existing condition that would prevent maximal recovery under the MIG.
Consequently, the applicant was not entitled to the disputed medical benefits and assessments.
No co-appearing lawyers found.
No judges found.