Dr. S. Hosseini

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

The respondent denied several treatment and assessment plans on the basis that the applicant's injuries were predominantly minor and subject to the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG due to psychological impairment and chronic pain.

The Tribunal found the applicant's injuries were predominantly minor, preferring the respondent's medical assessments over the applicant's, and noting inconsistencies in the applicant's self-reporting.

As the $3,500 MIG limit was exhausted, the disputed treatment plans were not reasonable and necessary.

Claims for an award and interest were also dismissed.

The applicant was struck by a vehicle while pushing her infant in a grocery cart and sought a determination of catastrophic impairment due to psychological injuries, along with ongoing Income Replacement Benefits (IRBs) and medical benefits.

The Tribunal found that while the applicant suffered a mental or behavioural disorder caused by the accident, her impairments were moderate rather than marked, and thus she did not meet the catastrophic impairment threshold.

However, the Tribunal granted the applicant's claim for post-104 week IRBs, finding she suffered a complete inability to engage in suitable employment based on vocational and psychological assessments.

Claims for specific physiotherapy and chiropractic treatment plans were dismissed for lack of evidence, though the insurer was ordered to pay HST on an approved psychological treatment plan.

A claim for a special award was dismissed.