10 total
Applicant held to Minor Injury Guideline; respondent's in-person psychological assessment preferred over applicant's virtual assessment.
The applicant sought statutory accident benefits following a motor vehicle accident but was denied by the respondent on the basis that her injuries fell within the Minor Injury Guideline (MIG).
The applicant argued she should be removed from the MIG due to a psychological condition, relying on a psychological assessment conducted via video call.
The Tribunal preferred the respondent's in-person psychological assessment, which found no psychological condition, noting it included validity testing and was conducted directly by a psychologist.
The Tribunal held the applicant to the MIG limit and dismissed the claims for disputed treatment plans and interest.
Application for accident benefits dismissed; applicant failed to prove injuries warranted removal from Minor Injury Guideline.
The applicant sought statutory accident benefits following a motor vehicle accident, arguing her injuries warranted removal from the Minor Injury Guideline (MIG) due to psychological impairments and chronic pain.
The Tribunal found the applicant failed to meet her burden of proof, noting a lack of corroborating clinical records from treating physicians to support the psychological diagnosis.
Relying on the respondent's insurer examinations, the Tribunal concluded the applicant's injuries were predominantly minor.
As the MIG limits were exhausted, the disputed treatment plans and claim for interest were dismissed.
Application for accident benefits dismissed as applicant failed to prove treatment plans were reasonable and necessary.
The applicant sought entitlement to statutory accident benefits for chiropractic, massage, psychotherapy, and catastrophic determination assessments following a 2017 motor vehicle accident.
The Licence Appeal Tribunal dismissed the application, finding the applicant failed to meet her evidentiary burden to prove the treatment and assessment plans were reasonable and necessary.
The Tribunal preferred the respondent's more current section 44 assessment reports over the applicant's outdated section 25 reports and noted the lack of consistent recommendations from treating physicians.
Application for accident benefits dismissed as 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 the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant failed to establish that she suffered from chronic pain, neurological/cognitive deficits, or psychological impairments caused by the accident that would warrant removal from the MIG.
As the $3,500 MIG limit had already been exhausted, the Tribunal dismissed the claims for additional psychological and physiotherapy treatment plans, as well as the claim for interest.
Applicant removed from Minor Injuries Guideline due to accident-related driving phobia; psychological treatment plans approved.
The respondent insurer denied funding for psychological assessments and treatment, arguing the applicant's injuries fell within the Minor Injuries Guideline (MIG).
The Tribunal found that the applicant suffered from a psychological injury, specifically a situational phobia related to driving and being a passenger, which warranted removal from the MIG.
The Tribunal preferred the evidence of the applicant's psychologist over the insurer's expert, noting the former's reliance on thorough psychometric testing.
The disputed treatment plans for psychological services were deemed reasonable and necessary.
Interest was awarded on the incurred assessment cost but not on the un-incurred treatment plan.
Reconsideration of accident benefits denial dismissed; adjudicator reasonably relied on applicant's statements refusing treatment.
The applicant sought reconsideration of a LAT decision that denied her claims for psychological, chiropractic, and massage therapy benefits.
She argued the adjudicator erred in fact and law, violated procedural fairness, and sought to introduce a new letter from her supervising psychologist to validate her psychological assessment report.
The adjudicator waived the late filing of the reconsideration request but dismissed it on the merits.
The adjudicator found the new letter did not meet the test for new evidence and would not have changed the outcome, as the original decision reasonably relied on the applicant's own statements to the insurer's assessor that she did not want or need the claimed treatments.
Application for accident benefits dismissed; injuries fell within the Minor Injury Guideline.
The applicant sought statutory accident benefits following a rear-end motor vehicle accident.
The respondent denied certain physiotherapy and psychological treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Licence Appeal Tribunal found that the applicant sustained predominantly minor injuries, noting the absence of any documented pre-existing condition that would prevent maximal recovery.
The Tribunal accepted the insurer's expert evidence over the applicant's psychological assessment, concluding that the disputed treatment plans and assessments were not reasonable and necessary.
The application was dismissed.
Application for medical benefits dismissed as applicant failed to prove treatments were reasonable and necessary.
The applicant sought entitlement to statutory accident benefits for psychological services, massage therapy, and chiropractic treatment following a motor vehicle accident.
The adjudicator found that the applicant failed to prove the treatment plans were reasonable and necessary.
The psychological assessment relied upon by the applicant was given little weight because it was unclear whether the supervising psychologist or the psychometrist conducted the clinical interview and made the diagnosis.
The respondent's psychological assessment, which found no impairment warranting a diagnosis, was preferred.
The claims for massage and chiropractic treatment were also dismissed as there was insufficient evidence they would provide relief comparable to physiotherapy.
Accident benefits claim dismissed as applicant's injuries fell within the Minor Injury Guideline limits.
The insurer deemed the applicant's physical injuries to be predominantly minor and subject to the $3,500 limit under the Minor Injury Guideline (MIG).
The applicant argued he sustained psychological injuries that removed him from the MIG.
The Tribunal found the applicant's self-reporting of psychological distress to be unreliable and contradictory to his family doctor's records.
The Tribunal concluded the applicant's injuries were minor, and because the MIG limits were exhausted, the disputed treatment plans and assessment costs were not reasonable and necessary.
Claims for an award, interest, and costs were dismissed.
Applicant removed from Minor Injury Guideline due to concussion; IRB claim dismissed for lack of employment.
The insurer denied income replacement benefits (IRBs) and medical benefits, arguing the applicant was not employed at the time of the accident and her injuries fell within the Minor Injury Guideline (MIG).
The Licence Appeal Tribunal found the applicant failed to prove she was employed pre-accident, dismissing the IRB claim.
However, the Tribunal determined the applicant sustained a concussion, removing her from the MIG.
The Tribunal denied a chiropractic treatment plan as not reasonable and necessary, but approved a psychological assessment treatment plan, reducing the hourly rate to comply with FSCO Guidelines, and awarded $1,847.46 plus interest.
No co-appearing lawyers found.
No judges found.