Dr. S. Taylor

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

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

The applicant argued he sustained a psychological injury that removed him from the MIG.

The Tribunal found no compelling evidence of a psychological injury, preferring the respondent's psychological assessment over the applicant's, as it was more consistent with the clinical notes and the applicant's return to work.

The application for disputed treatment plans, an award, and interest was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the respondent's denial of several treatment plans (OCF-18s) for chiropractic and psychological treatment.

The adjudicator found that the applicant failed to prove the treatment plans were reasonable and necessary.

Medical evidence, including records from the applicant's family physician and an insurer's examination, indicated the physical injuries had resolved.

For the psychological treatment, the adjudicator found the requested re-assessments and administrative costs were not justified by the evidence or the FSCO Professional Services Guideline.

The application was dismissed, and claims for interest and a special award were denied.

The applicant sought $12,580.00 for a multidisciplinary chronic pain program following a 2015 motor vehicle accident.

The respondent denied the treatment plan, arguing the applicant's current pain complaints were not accident-related and she had reached maximum medical recovery.

The Tribunal found the proposed program lacked specificity and the applicant failed to prove it was reasonable and necessary.

The Tribunal also noted inconsistencies in the applicant's reporting of her injuries and preferred the respondent's medical evidence, which concluded the applicant had achieved maximum medical improvement.

The application was dismissed.