Dr. Rodrigo Castro

The applicant sought a determination that she sustained a catastrophic impairment (CAT) and was entitled to post-104-week income replacement benefits (IRBs) following a 2018 motor vehicle accident.

The Tribunal found that the applicant did not meet the CAT threshold under Criterion 7, as her evidence failed to transparently apply the AMA Guides' methodology and improperly double-counted impairments, whereas the respondent's assessments credibly established a 15% Whole Person Impairment.

The Tribunal also found the applicant did not meet Criterion 8, preferring the respondent's functional observations showing independence in daily activities over the applicant's self-reported limitations.

Finally, the Tribunal dismissed the claim for post-104-week IRBs, concluding the applicant failed to prove a complete inability to engage in reasonably suited employment, given evidence of ongoing functional capacity and post-accident earnings.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to five physiotherapy treatment plans, a general practitioner assessment, and a social work assessment.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove on a balance of probabilities that the proposed treatments and assessments were reasonable and necessary.

The Tribunal preferred the respondent's section 44 medical assessments, which concluded the applicant had reached maximum medical improvement, over the applicant's evidence, noting that the applicant's family physician records lacked accident-related complaints.

The applicant sought entitlement to statutory accident benefits for psychological and physiotherapy treatment plans, a general practitioner's assessment, and a special award following a 2019 motor vehicle accident.

The Licence Appeal Tribunal found the applicant was partially entitled to one psychological treatment plan, preferring the treating psychiatrist's clinical notes over the respondent's section 44 assessor.

The remaining psychological and physiotherapy plans were denied as the applicant failed to prove they were reasonable and necessary, with the Tribunal finding the applicant had reached maximum medical improvement physically.

The claim for the general practitioner's assessment was barred by issue estoppel from a previous Tribunal decision.

No special award was granted as the insurer's conduct was not unreasonable.

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

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

The Tribunal found that the applicant suffered from chronic pain with functional impairments, removing her from the MIG.

The Tribunal ordered the respondent to pay for the disputed physiotherapy, psychological, and chronic pain treatment plans, finding them reasonable and necessary.

The applicant's claim for a special award for unreasonable delay was dismissed, but interest on overdue benefits was granted.

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

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

The Tribunal found the applicant failed to prove chronic pain or psychological impairments warranting removal from the MIG, citing inconsistent self-reporting to assessors.

However, the Tribunal ordered the insurer to pay for social work, general practitioner, and psychological assessments because the insurer's denial notices contained boilerplate language and failed to comply with the medical reasons requirement under s. 38(8) of the Schedule.