4 total
Application for non-earner benefits and treatment plans dismissed due to inconsistent evidence and pre-existing injuries.
The applicant sought statutory accident benefits following a motor vehicle accident in August 2022, claiming entitlement to a non-earner benefit and two physiotherapy treatment plans.
The respondent denied the benefits, arguing the applicant's impairments stemmed from a prior 2019 accident and that he did not suffer a complete inability to carry on a normal life.
The Tribunal found the applicant's evidence highly inconsistent regarding his pre- and post-accident functioning and employment status.
Relying on the consistent evidence of the respondent's assessors and the applicant's own treating records, the Tribunal concluded the applicant failed to prove his entitlement to the non-earner benefit or the treatment plans.
The application was dismissed, and the respondent's request for costs due to late service of documents was also denied.
Application for accident benefits dismissed; proposed chiropractic treatments not reasonable and necessary given pre-existing degenerative conditions.
The applicant sought entitlement to statutory accident benefits following a motor vehicle accident, including several chiropractic treatment plans, an occupational therapy assessment, and orthotics.
The Licence Appeal Tribunal dismissed the application.
The Tribunal found the chiropractic plans were not reasonable and necessary given the applicant's pre-existing chronic pain, degenerative imaging, and the passive nature of the proposed modalities, preferring the insurer's section 44 medical examination report.
The occupational therapy assessment was denied as duplicative, and the orthotics claim was found to have been previously paid by the respondent.
Application for accident benefits dismissed; injuries fall within Minor Injury Guideline and IRB test not met.
The applicant sought statutory accident benefits following a motor vehicle accident.
The Tribunal found that the applicant's injuries fell within the Minor Injury Guideline (MIG), as he failed to establish a pre-existing condition or chronic pain with functional impairment that would warrant removal.
The Tribunal also dismissed the claim for an income replacement benefit, finding the applicant did not meet his onus to establish a substantial inability to perform the essential tasks of his employment, and the respondent properly relied on an Insurer Examination to discontinue the benefit.
Accident benefits denied; applicant failed to prove shoulder injury was caused by the motor vehicle accident.
The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant contended that a right shoulder injury requiring surgery warranted removal from the MIG.
The Tribunal found that the applicant failed to prove the shoulder injury was caused by the accident, noting a two-year delay in reporting the pain and medical records suggesting a workplace injury.
As the applicant remained within the MIG and the limits were exhausted, the claims for treatment plans, attendant care, interest, and an award were dismissed.
No co-appearing lawyers found.
No judges found.