Dr. Y. K. M. Ko

The applicant sought medical and rehabilitation benefits under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The respondent insurer denied the treatment plans, which included a chronic pain assessment, attendant care assessment, chiropractic treatment, massage therapy, and assistive devices.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to demonstrate on a balance of probabilities that the proposed goods and services were reasonable and necessary.

The adjudicator noted a lack of contemporaneous medical evidence supporting ongoing functional impairment and relied on insurer's examination reports which concluded the applicant did not suffer from structural injuries or significant psychological impairment.

As no benefits were payable, the claim for interest was also dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, arguing his injuries fell outside the Minor Injury Guideline (MIG) due to chronic pain with functional impairment and pre-existing conditions.

The Tribunal found that the applicant's accident-related pain resolved shortly after the accident and that a subsequent workplace incident caused his ongoing back issues.

Furthermore, the applicant failed to demonstrate that his pre-existing conditions impeded his recovery within the MIG limits.

As the MIG limits were exhausted, the application for further treatment plans and interest was dismissed.