Dr. R. Williams

The applicant was injured in a motor vehicle accident and sought payment for three medical assessments (neurological, chronic pain, and physiatry) under the Statutory Accident Benefits Schedule.

The respondent denied the benefits on the basis that they were not reasonable and necessary.

The Tribunal found that the applicant failed to meet his burden of establishing that the assessments were reasonable and necessary, noting a lack of objective medical evidence and inconsistencies in the applicant's self-reported functionality compared to pre-accident records and independent assessments.

The application was dismissed, and claims for interest and an award for unreasonable delay were also denied.

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

The respondent denied a treatment plan for chiropractic services, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant contended that pre-existing lower back pain precluded his recovery within the MIG limits.

The Tribunal found that the applicant failed to establish a pre-existing condition that would prevent maximal recovery within the MIG, relying on the respondent's uncontradicted physiatrist reports and clinical notes showing improvement.

Consequently, the applicant was not entitled to the disputed treatment plan or interest.

The respondent's request for costs was denied as the applicant's conduct was not unreasonable, frivolous, vexatious, or in bad faith.

The applicant's estate sought a non-earner benefit following a motor vehicle accident.

Prior to the accident, the applicant had been diagnosed with progressive, metastatic breast cancer and chronic renal failure.

The Tribunal dismissed the application, finding that the applicant's impairments and declining ability to lead a normal life were caused by her terminal cancer rather than the soft-tissue injuries sustained in the accident.

The Tribunal concluded the applicant did not suffer a complete inability to carry on a normal life as a result of the accident.

Claims for interest and costs were also dismissed.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits.

The respondent denied the claims on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit had been exhausted.

The applicant argued they suffered from a psychological impairment and chronic pain taking them outside the MIG.

The Tribunal found insufficient evidence of a psychological impairment or chronic pain caused by the accident, preferring the respondent's physiatry assessment over the applicant's delayed psychological reporting.

The Tribunal concluded the injuries were predominantly minor, dismissing the application and denying the respondent's request for costs.

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

The respondent denied claims for a psychological assessment and treatment, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the respondent failed to comply with the notice requirements under s. 38(8) of the Schedule because its Explanation of Benefits did not provide valid medical reasons for denying the psychological assessment.

Consequently, the applicant was removed from the MIG, and the cost of the assessment was payable.

The Tribunal also found the psychological treatment plan reasonable and necessary, as the respondent provided no competing psychological evidence.

The claim for an award under Regulation 664 was dismissed, but interest was awarded on the overdue benefits.