3 total
Application for income replacement benefits dismissed due to inconsistent presentation and lack of full effort during medical assessments.
The applicant sought an income replacement benefit (IRB) following a motor vehicle accident, claiming physical and psychological impairments prevented her from working.
The Tribunal reviewed conflicting medical assessments and found the applicant's presentation of pain and limitation to be inconsistent and lacking full effort.
Preferring the respondent's medical evidence, the Tribunal concluded the applicant did not suffer a substantial inability to perform the essential tasks of her employment.
The application for IRBs, interest, and a special award was dismissed.
Application for statutory accident benefits dismissed as proposed treatment and assessment plans were not reasonable and necessary.
The applicant was injured in a motor vehicle accident and sought various statutory accident benefits, including treatment plans for occupational therapy, a chronic pain program, and assessments for neuropsychological, chronic pain, functional cognitive, and catastrophic impairment, as well as a SPECT scan.
The insurer denied the claims.
The Licence Appeal Tribunal dismissed the application in its entirety, finding that the applicant failed to demonstrate on a balance of probabilities that the proposed plans were reasonable and necessary.
The Tribunal relied on insurer examination reports and surveillance evidence showing the applicant engaging in normal activities, which contradicted the applicant's self-reported functional limitations and the opinions of his assessors.
Application for post-104 week income replacement benefits dismissed as applicant failed to prove complete inability.
The applicant sought an income replacement benefit (IRB) of $79.00 per week beyond the 104-week mark following a motor vehicle accident.
The respondent insurer denied the benefit, arguing the applicant did not suffer a complete inability to engage in suitable employment.
The Tribunal reviewed medical and vocational evidence, finding the respondent's insurer examinations persuasive, particularly as they directly addressed the post-104 week test.
The applicant's medical evidence, while supporting her complaints of pain and psychological issues, failed to address whether she suffered a complete inability to work.
The Tribunal dismissed the application for IRBs, interest, and costs, noting the applicant failed to meet her evidentiary burden.
No co-appearing lawyers found.
No judges found.