Dr. Tu

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

The respondent denied various chiropractic and psychological treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant failed to prove on a balance of probabilities that he suffered from a pre-existing condition, a psychological impairment, or chronic pain that would warrant removal from the MIG.

The Tribunal preferred the respondent's psychological and physical assessments, noting a lack of psychological symptoms in the treating practitioners' records and no evidence of functional impairment.

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

The applicant sought entitlement to statutory accident benefits for chiropractic, psychological, and occupational therapy treatment plans following a motor vehicle accident.

The Tribunal found that the applicant failed to prove the chiropractic, occupational therapy, and first psychological treatment plans were reasonable and necessary.

However, the Tribunal ordered the respondent to pay the second psychological treatment plan because its denial letter failed to comply with the notice requirements under section 38(8) of the Schedule.

The applicant's claim for an award for unreasonable delay was dismissed.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits.

The respondent insurer denied a treatment plan for a chronic pain assessment, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found the applicant established he suffers from chronic pain with functional impairments, warranting removal from the MIG.

The Tribunal ordered the respondent to pay $2,460.00 for the chronic pain assessment and interest on overdue benefits, but denied the applicant's request for a special award under s. 10 of Regulation 664.

The applicant sought accident benefits following a motor vehicle collision.

The adjudicator found that the applicant's injuries warranted removal from the Minor Injury Guideline (MIG) due to chronic pain syndrome, satisfying several criteria under the AMA Guides.

However, the applicant's claims for a non-earner benefit and a chiropractic treatment plan were dismissed.

The adjudicator concluded that the applicant did not suffer a complete inability to carry on a normal life, as she retained significant functional capacity to engage in pre-accident activities.

The treatment plan was denied because the applicant failed to provide substantive evidence demonstrating it was reasonable and necessary.

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

The respondent denied several treatment plans and expenses 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's physical injuries were soft tissue in nature and that she failed to establish removal from the MIG on the basis of chronic pain or psychological impairment.

The Tribunal preferred the respondent's section 44 psychological assessment over the applicant's section 25 assessment.

As the applicant remained within the MIG, the disputed treatment plans and expenses were not payable.

The applicant sought statutory accident benefits for physical therapy, a chronic pain assessment, and a psychological assessment following a 2016 motor vehicle accident.

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

The physical therapy claims lacked contemporaneous medical support, the chronic pain assessor was not qualified to diagnose chronic pain, and the psychological complaints were pre-existing and unrelated to the accident.

The application was dismissed and no interest was payable.

The applicant sought payment for four treatment plans for chiropractic services and other goods following a motor vehicle accident.

The respondent denied the plans based on insurer's examinations concluding the applicant had reached maximum medical recovery.

The Tribunal found that one treatment plan for $1,977.05 was reasonable and necessary to determine if maximum medical recovery had been reached, noting the insurer's assessors failed to review the family physician's clinical notes.

The remaining three treatment plans were dismissed due to a lack of contemporaneous complaints of pain or insufficient evidence justifying their necessity.

The applicant sought medical and rehabilitation benefits following a motor vehicle accident, which the respondent insurer denied.

The Licence Appeal Tribunal found that the applicant was entitled to the cost of a neurological assessment, as his treating physician diagnosed a nerve injury and the insurer's assessors lacked access to those medical records.

However, the Tribunal dismissed the claims for a chronic pain assessment, a Functional Ability Evaluation, psychological treatment, and transportation costs for an orthopaedic assessment, finding them not reasonable and necessary due to pre-existing conditions, lack of contemporaneous evidence, and unpersuasive expert reports.

The claim for a special award under Regulation 664 was also dismissed.