6 total
Applicant awarded funding for psychological and occupational therapy treatment plans but denied non-earner benefits.
The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit and funding for various treatment plans.
The Licence Appeal Tribunal found that the applicant was not entitled to the non-earner benefit because he failed to prove a complete inability to carry on a normal life.
However, the Tribunal approved treatment plans for occupational therapy services, an occupational therapy assessment, and psychological assessments, finding them reasonable and necessary due to the applicant's accident-related psychological impairments.
A claim for physiotherapy services was denied as the applicant had reached maximum therapeutic benefit.
The Tribunal also awarded interest on the overdue payments but declined to order a special award under s. 10 of Reg. 664.
Tribunal granted psychological and driving reintegration benefits but denied speech language pathology treatment.
The applicant sought statutory accident benefits following a motor vehicle accident, disputing the respondent's denial of several treatment plans.
The Licence Appeal Tribunal found the applicant was entitled to psychological services and a driver's reintegration assessment, as medical evidence and consistent reporting supported her psychological symptoms and driving anxiety.
However, the Tribunal denied the claims for a speech language pathology assessment and treatment, finding the applicant's self-reported cognitive and communication issues were contradicted by multiple assessors who observed no such impairments.
The Tribunal awarded interest on the overdue benefits but declined to order an award under s. 10 of O. Reg. 664, finding the respondent did not unreasonably withhold or delay payment.
Application for post-104 income replacement benefits dismissed as applicant failed to prove complete inability to work.
The applicant was injured in a motor vehicle accident and received income replacement benefits (IRBs) for 104 weeks.
The respondent terminated IRBs at the 104-week mark.
The applicant applied to the Licence Appeal Tribunal for ongoing IRBs.
The Tribunal held that the stricter post-104 test applied, requiring the applicant to prove a complete inability to engage in any employment for which she is reasonably suited by education, training, or experience.
The Tribunal found the applicant's expert evidence unpersuasive and noted the lack of supportive evidence from her long-term family doctor.
The application for ongoing IRBs and interest was dismissed.
Application for accident benefits dismissed; injuries found to be minor and MIG limit exhausted.
The applicant sought statutory accident benefits following a motor vehicle accident.
The insurer determined the applicant's injuries fell within the Minor Injury Guideline (MIG) and denied further treatment plans as the $3,500 limit was exhausted.
The applicant argued he suffered from chronic pain and psychological impairments warranting removal from the MIG.
The Tribunal found insufficient evidence of chronic pain or psychological impairment, preferring the insurer's psychological assessment over the applicant's.
The Tribunal concluded the injuries were predominantly minor, and since the MIG limit was exhausted, the disputed treatment plans were not payable.
Accident benefits application dismissed as proposed assessments were not reasonable and necessary and forms were defective.
The applicant sought statutory accident benefits following a rear-end motor vehicle collision.
The respondent initially placed the applicant in the Minor Injury Guideline (MIG) but later removed her due to psychological issues.
The applicant claimed entitlement to physiotherapy services, a driver evaluation assessment, and a neuropsychological assessment.
The Tribunal dismissed the application, finding the physiotherapy claim was submitted in an incorrect format without the applicant's signature.
The Tribunal further held that the driver evaluation and neuropsychological assessments were not reasonable and necessary, as the applicant was already driving, had undergone multiple prior assessments, and lacked sufficient evidence of a head injury.
Application for accident benefits dismissed as applicant failed to prove treatments were reasonable and necessary.
The applicant was injured in a motor vehicle accident and sought medical benefits for physiotherapy and costs of examination for orthopaedic, attendant care, and psychological assessments.
The insurer denied the benefits, arguing the applicant's injuries had resolved or were related to a subsequent accident.
The Licence Appeal Tribunal dismissed the application, finding the applicant failed to prove the treatments and assessments were reasonable and necessary.
The Tribunal gave significant weight to the insurer's examination reports and noted the applicant's lack of candor regarding a second motor vehicle accident.
No co-appearing lawyers found.
No judges found.