6 total
Application for accident benefits dismissed; applicant failed to prove psychological impairment warranting removal from MIG.
The applicant sought statutory accident benefits following a motor vehicle accident, claiming a psychological impairment warranted removal from the Minor Injury Guideline (MIG).
The Tribunal weighed competing psychological assessments and preferred the respondent's expert, who found no accident-related psychological impairment under the DSM-5.
The Tribunal concluded the applicant failed to prove an injury warranting removal from the MIG.
Consequently, the claims for treatment plans beyond the MIG limit and interest were dismissed.
Application for accident benefits dismissed; injuries fell within the Minor Injury Guideline and limits were exhausted.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied several treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant argued for removal from the MIG due to chronic pain syndrome and psychological impairment.
The Tribunal found insufficient medical evidence to support a diagnosis of chronic pain syndrome.
The Tribunal also preferred the respondent's psychological assessment over the applicant's, concluding there was no clinically significant psychological impairment.
As the applicant's injuries were predominantly minor and the $3,500 MIG limit was exhausted, the application for further benefits and a section 10 award was dismissed.
Applicant limited to Minor Injury Guideline cap; partial income replacement benefit awarded.
The adjudicator found that the applicant's injuries were predominantly minor, as he failed to establish a psychological impairment or chronic pain syndrome that would remove him from the Minor Injury Guideline.
Consequently, his medical and rehabilitation benefits were capped at $3,500, and his claims for further treatment were dismissed.
The adjudicator partially allowed the claim for an income replacement benefit, granting it for a limited period during which the applicant was substantially unable to perform the heavy physical tasks of his construction business.
The claim for HST on an income replacement report was denied, as the Schedule does not mandate HST payments beyond the statutory cap for such reports.
Application for accident benefits beyond the Minor Injury Guideline limit dismissed for lack of evidence.
The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to medical and rehabilitation benefits beyond the $3,500 limit of the Minor Injury Guideline (MIG) due to psychological impairment, chronic shoulder pain, and a pre-existing heart condition (COPD).
The Tribunal found that the applicant's psychological symptoms were sequelae of his physical injuries rather than a free-standing impairment, and that he failed to establish chronic pain syndrome.
Furthermore, the applicant did not prove that his pre-existing COPD would prevent him from achieving maximal medical recovery under the MIG.
As the applicant did not address his claim for a non-earner benefit in his submissions, it was denied.
The application was dismissed in its entirety.
Application for accident benefits dismissed; injuries fell within the Minor Injury Guideline and IRB criteria unmet.
The applicant sought statutory accident benefits following a motor vehicle accident, claiming his injuries fell outside the Minor Injury Guideline (MIG) and seeking further chiropractic treatments and income replacement benefits (IRBs).
The adjudicator found that the applicant failed to provide compelling medical evidence to prove his injuries were non-MIG, relying instead on the insurer's medical assessments which diagnosed minor strains and no psychological impairment.
Consequently, the claim for further medical benefits was denied as the $3,500 MIG limit had been reached.
The claim for IRBs was also dismissed, as the evidence demonstrated the applicant was not substantially unable to perform the essential tasks of his employment.
Treatment plans found reasonable and necessary; insurer's MIG assessment rejected due to psychological injuries.
The applicant was injured in a rear-end motor vehicle accident and sought statutory accident benefits for physical and psychological treatment.
The respondent insurer denied two treatment plans on the basis of an insurer's examination that concluded the injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found the treatment plans reasonable and necessary, preferring the evidence of the treating psychologist and other insurer's examiners who noted ongoing pain and psychological disturbance over the physician who erroneously applied the MIG.
The applicant was awarded the claimed medical benefits plus interest.
No co-appearing lawyers found.
No judges found.