Dr. R.J.F. Saplys

The applicant was injured in a motor vehicle accident and sought various medical and rehabilitation benefits under the Statutory Accident Benefits Schedule, which the respondent insurer denied.

The applicant applied to the Licence Appeal Tribunal to dispute the denials of treatment plans for physiotherapy, a neuro-optometric assessment, an orthopaedic assessment, and a functional abilities evaluation.

The Tribunal found that the disputed treatment plans were not reasonable and necessary, relying heavily on the respondent's insurer's examinations which concluded the applicant had reached maximum medical recovery and required no further intervention.

One physiotherapy treatment plan had already been approved by the respondent prior to the hearing.

The Tribunal dismissed the claims for the remaining benefits, interest, a special award, and costs.

The appellant sought leave to appeal a preliminary arbitration order requiring him to attend two insurer medical examinations (IMEs) to assess his entitlement to post-104 week income replacement benefits.

The Director's Delegate declined to exercise discretion under Rule 50.2 of the Dispute Resolution Practice Code to accept the appeal.

The Delegate found that the arbitrator's decision was a preliminary procedural order, and accepting the appeal would add expense and delay rather than facilitate a cost-effective resolution.

The arbitrator had properly considered the relevant criteria for IME requests, including the change in the disability test and procedural fairness, and the appeal did not raise novel or important issues warranting intervention.

The applicant sought statutory accident benefits for housekeeping and home maintenance services, as well as the cost of an assessment, following a motor vehicle accident.

The arbitrator found the applicant's evidence regarding his pre- and post-accident housekeeping activities to be unreliable, inconsistent, and exaggerated.

The arbitrator concluded that the applicant did not suffer a substantial inability to perform his housekeeping tasks and that the claimed expenses were not reasonable or necessary.

The request for the cost of the assessment was also denied as it amounted to a duplication of services.

The application was dismissed.

The applicant was injured in a minor motor vehicle accident and claimed income replacement benefits, alleging he was unable to work as a truck driver due to headaches and concentration problems.

The insurer denied the benefits based on insurer medical examinations.

The arbitrator found the applicant's evidence of disability to be sparse, contradictory, and unsupported by medical evidence.

The medical experts concluded the applicant suffered only minor injuries and was not disabled from working.

The application for income replacement benefits was dismissed.