6 total
Reconsideration request dismissed; applicant failed to establish errors of law or fact in catastrophic impairment denial.
The applicant requested a reconsideration of a Licence Appeal Tribunal decision that found she was not catastrophically impaired and denied her claims for attendant care benefits.
The applicant argued the Tribunal failed to properly engage with her expert's diagnosis of Somatic Symptom Disorder and improperly relied on surveillance evidence.
The Vice-Chair dismissed the request, finding the applicant was attempting to re-litigate the Tribunal's weighing of the evidence rather than identifying an error of law or fact under Rule 18.2.
Application for catastrophic impairment and various accident benefits dismissed; applicant failed to meet Criterion 8 threshold.
The applicant was involved in a motor vehicle accident and sought statutory accident benefits, including a determination of catastrophic impairment under Criterion 8 (mental and behavioural disorders).
The Tribunal found that the applicant did not sustain a catastrophic impairment, as she did not demonstrate marked impairments in three out of four domains of functioning.
The Tribunal preferred the evidence of the respondent's assessors, who found the applicant capable of living independently and managing daily activities.
The applicant's claims for attendant care benefits, housekeeping benefits, and various treatment plans were also dismissed, as she failed to prove they were reasonable and necessary or incurred in accordance with the Schedule.
Applicant designated catastrophically impaired due to marked impairment in social functioning following motor vehicle accident.
The applicant, who was 6 years old at the time of the motor vehicle accident, sought a determination of catastrophic impairment under Criterion 8 of the Statutory Accident Benefits Schedule due to mental and behavioural disorders.
The Tribunal found that the applicant sustained a Class 4 marked impairment in the domain of social functioning, relying on the applicant's psychiatric expert who linked the psychological diagnoses to the applicant's avoidance of interpersonal relationships and severe social withdrawal.
The Tribunal dismissed the claims for an assessment plan and an OCF-6 invoice as the applicant provided no evidence or submissions to support them.
Applicant awarded non-earner benefits after motor vehicle accident exacerbated pre-existing conditions; special award denied.
The applicant sought a non-earner benefit (NEB), an award for unreasonable delay, interest, and costs following a motor vehicle accident.
The respondent denied the NEB, arguing the applicant's impairments were pre-existing and temporary.
The Tribunal found that the accident exacerbated the applicant's pre-existing physical and psychological conditions, resulting in a complete inability to carry on a normal life.
The applicant was awarded the NEB and interest.
However, the Tribunal dismissed the claims for a special award and costs, finding the respondent did not act unreasonably, frivolously, or in bad faith.
Application for accident benefits dismissed due to lack of corroborating medical evidence supporting treatment plans.
The applicant sought entitlement to various statutory accident benefits following a 2018 motor vehicle accident, including multiple treatment plans for social work, case management, vision therapy, and psychological services, as well as reimbursement for out-of-pocket expenses.
The Licence Appeal Tribunal dismissed the application in its entirety.
The adjudicator found that the applicant failed to meet the burden of proving the claimed benefits were reasonable and necessary, largely due to a lack of contemporaneous, corroborating medical evidence and a failure to properly reference evidence in the document brief.
Claims for interest and an award for unreasonable delay were consequently denied.
Post-104-week IRB claim dismissed as applicant failed to prove complete inability to engage in suitable employment.
The applicant was injured in a motor vehicle accident in 2016, sustaining a severe right elbow fracture.
He received income replacement benefits (IRBs) for the first 104 weeks, after which the respondent denied further IRBs.
The applicant applied to the Licence Appeal Tribunal, claiming a complete inability to engage in any suitable employment due to physical pain, fear of reinjury, and psychological impairments including depression and anxiety.
The adjudicator dismissed the application, finding that the applicant's physical injuries had healed and his psychological issues were primarily related to boredom and lack of motivation rather than a complete inability to work.
The adjudicator preferred the respondent's expert evidence, which demonstrated the applicant retained the functional capacity and vocational aptitude for alternative employment.
No co-appearing lawyers found.
No judges found.