29 total
Applicant's injuries found to be predominantly minor; removal from Minor Injury Guideline denied.
The applicant sought statutory accident benefits following a rear-end motor vehicle accident.
The respondent insurer denied several treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit had been exhausted.
The Tribunal found that the applicant failed to prove that pre-existing conditions, psychological impairments, or chronic pain warranted removal from the MIG.
The Tribunal preferred the insurer's psychological assessment over the applicant's, noting inconsistencies and a lack of reporting to the family doctor.
As the injuries were predominantly minor and the MIG limit was exhausted, the disputed treatment plans were not payable.
Application for statutory accident benefits dismissed as applicant failed to prove treatment plans were reasonable and necessary.
The applicant sought statutory accident benefits following a motor vehicle accident, disputing the insurer's denial of several treatment plans for chiropractic and psychological services, as well as a chronic pain assessment.
The Tribunal found that the applicant failed to prove the chiropractic treatment plans were reasonable and necessary, preferring the insurer's physiatrist's evidence that there was no ongoing physical impairment.
The Tribunal also dismissed the claim for further psychological services, noting the insurer had already approved a partially reasonable treatment plan and the applicant provided no evidence of ongoing need.
Finally, the Tribunal denied the chronic pain assessment due to a lack of objective evidence establishing that the accident was a necessary cause of the applicant's pain.
The application was dismissed in its entirety.
Application for accident benefits dismissed as applicant failed to prove injuries exceeded the Minor Injury Guideline.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied medical benefits beyond the $3,500 Minor Injury Guideline (MIG) limit.
The applicant argued he sustained a psychological impairment and chronic pain exceeding the MIG.
The Tribunal found the applicant failed to discharge his evidentiary onus, noting a lack of objective medical evidence and giving little weight to the psychological reports which relied solely on self-reporting.
The Tribunal concluded the injuries were predominantly minor and dismissed the application.
Application for accident benefits dismissed as injuries fell within the Minor Injury Guideline.
The respondent denied several treatment plans for chiropractic and psychological care on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Licence Appeal Tribunal found that the applicant sustained predominantly minor soft tissue injuries and failed to establish that he suffered from chronic pain or a psychological impairment that would remove him from the MIG.
As the $3,500 MIG funding limit had been exhausted, the claims for additional medical benefits were dismissed, along with claims for interest and an award for unreasonable withholding of benefits.
Statutory accident benefits denied; applicant's injuries fell within the Minor Injury Guideline.
The applicant sought statutory accident benefits for chiropractic and psychological services following a motor vehicle accident.
The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant did not sustain a psychological impairment, chronic pain syndrome, or carpal tunnel syndrome as a result of the accident, and failed to prove a causal link between her severe bilateral neural foraminal stenosis and the accident.
The Tribunal concluded the applicant's injuries were predominantly minor and subject to the MIG limit.
The disputed treatment plans and assessment were deemed not reasonable and necessary.
Claims for an award and interest were dismissed.
Tribunal approves most chiropractic and psychological treatment plans but denies duplicative chiropractic plan and cognitive assessment.
The insurer denied several treatment plans for chiropractic services, psychological treatment, and a functional cognitive assessment, arguing the applicant's injuries fell within the Minor Injury Guideline.
The Tribunal found that three of the four chiropractic treatment plans and the psychological treatment plan were reasonable and necessary, ordering the insurer to pay them with interest.
However, the Tribunal denied the fourth chiropractic plan as it was duplicative and lacked a home exercise progression, and denied the cognitive assessment due to a lack of evidence of significant cognitive impairment.
Claim for non-earner benefits dismissed as applicant failed to prove complete inability to carry on a normal life.
The applicant sought non-earner benefits following a motor vehicle accident.
The respondent argued the applicant was barred from claiming non-earner benefits because he was eligible for income replacement benefits.
The Tribunal found the applicant was not barred, as the respondent failed to provide an election form and the applicant did not ultimately qualify for income replacement benefits.
However, the Tribunal dismissed the claim for non-earner benefits, finding the applicant's medical evidence failed to establish a complete inability to carry on a normal life under the Heath test.
Applicant awarded ongoing income replacement benefits due to accident-related psychological impairments preventing employment.
The applicant sought income replacement benefits (IRBs) following a motor vehicle accident.
The insurer terminated IRBs after 104 weeks, arguing the applicant did not meet the test for complete inability to work.
The Tribunal found that while the applicant failed to prove physical impairment, he successfully established that his psychological impairments, caused by the accident, rendered him completely unable to engage in any employment for which he was reasonably suited.
The Tribunal awarded IRBs from November 15, 2015, ongoing, with interest.
The respondent's request for costs was denied.
Applicant removed from Minor Injury Guideline due to severe psychological impairment; psychological treatment plan approved.
The applicant was struck by a vehicle while crossing an intersection as a pedestrian.
She applied for accident benefits, but the respondent insurer denied treatment plans for psychological and physiotherapy services, arguing her injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant's severe major depressive disorder and situational phobia, as diagnosed by her psychologist, removed her from the MIG.
The Tribunal ordered payment for the psychological services as reasonable and necessary, but denied the physiotherapy services due to insufficient evidence supporting their necessity.
No co-appearing lawyers found.
No judges found.