Dr. E. Silver

The applicant was struck by a vehicle as a pedestrian and sought statutory accident benefits, including a determination of catastrophic impairment, income replacement benefits (IRBs), and various medical benefits.

The Tribunal found that the applicant did not sustain a catastrophic impairment, as his physical and psychological impairments did not meet the 55% whole person impairment threshold under criteria 6 and 7, nor did he suffer marked impairments in three domains under criterion 8.

The Tribunal also dismissed the claim for IRBs, noting the applicant had returned to work for nearly three years post-accident and failed to demonstrate a complete inability to engage in suitable employment.

Claims for a functional abilities evaluation and worksite assessment were dismissed as not reasonable and necessary.

The applicant was awarded minor amounts for treatment plan form fees and interest on those amounts, but the claim for a special award was dismissed as the insurer's denials were not unreasonable.

The applicant sought income replacement benefits and funding for a chiropractic treatment plan following a motor vehicle accident.

The adjudicator found that the applicant failed to meet her burden of proving a substantial inability to perform the essential tasks of her pre-accident employment, relying on insurer's examination reports that found no physical or psychological disability.

The adjudicator also denied the treatment plan, finding it was not reasonable and necessary as the applicant had fully recovered from her soft tissue injuries.

The application was dismissed in its entirety.

The applicant sought a $2,200 psychological assessment following a motor vehicle accident, arguing his injuries fell outside the Minor Injury Guideline (MIG) due to chronic pain and psychological impairments.

The Tribunal found the applicant's physical injuries were minor soft tissue injuries that resolved within months, and that his subsequent pain complaints were related to a second accident and a fall.

The Tribunal also rejected the applicant's psychological claims, finding his symptoms arose nearly two years post-accident and were likely caused by situational stressors rather than the subject accident.

The application was dismissed, and the applicant was found not entitled to the disputed treatment plan or interest.

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

The respondent initially placed the applicant in the Minor Injury Guideline but later removed him.

The Tribunal found that proposed chiropractic treatments were not reasonable and necessary, as the applicant had reached maximum medical recovery and past treatments provided little relief.

However, the Tribunal approved a chronic pain assessment, finding it reasonable and necessary because the applicant met the AMA Guides criteria for chronic pain syndrome and had been diagnosed with chronic pain by multiple practitioners.

Claims for a special award and costs were dismissed.

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

The respondent determined the applicant sustained a minor injury, subjecting her to the Minor Injury Guideline (MIG) and its $3,500 funding limit, and denied her claims for non-earner benefits and certain treatment plans.

The Tribunal found that the applicant's injuries were predominantly minor soft-tissue injuries and that her pre-existing chronic pain and psychological issues were not materially exacerbated by the accident.

The Tribunal preferred the respondent's expert evidence, which incorporated a review of pre-accident medical records, over the applicant's experts who relied solely on self-reporting.

The application was dismissed, as the applicant failed to prove her injuries fell outside the MIG or that she suffered a complete inability to carry on a normal life.

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

The respondent insurer determined the applicant's injuries fell within the Minor Injury Guideline (MIG) and limited medical and rehabilitation benefits to $3,500.

The applicant argued that a pre-existing neck condition prevented maximal recovery within the MIG limit.

The Tribunal found the applicant failed to provide compelling medical evidence that the pre-existing condition impeded recovery, preferring the expert opinion of the insurer's examiner over the clinical notes of the applicant's family physician.

The Tribunal held the applicant was subject to the MIG limit but was entitled to partial payment of a physiotherapy treatment plan up to the remaining $84.09 of the limit, plus interest.

The applicant sought various medical and rehabilitation benefits following a 2019 motor vehicle accident.

The Tribunal found the applicant was removed from the Minor Injury Guideline due to a psychological impairment, entitling her to an in-home assessment.

However, claims for a chronic pain assessment, physiatry assessment, and physiotherapy were dismissed as the applicant failed to prove they were reasonable and necessary, largely due to a lack of objective medical evidence and failure to produce pre-accident records.

A claim for the balance of a psychological treatment plan was also dismissed because the provider was a psychotherapist, not a psychologist, and the insurer's lower hourly rate was deemed reasonable.

Claims for an award and costs were dismissed.

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

The respondent initially placed the applicant in the Minor Injury Guideline (MIG) but later removed him due to psychological injuries.

The applicant sought funding for a chiropractic treatment plan, which the respondent denied.

The Tribunal found the treatment plan was not reasonable and necessary, as there was no compelling contemporaneous evidence supporting it, and preferred the insurer's examination report over the applicant's family physician's records.

Claims for interest and an award for unreasonable delay were also dismissed.

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

The respondent insurer deemed her injuries to fall within the Minor Injury Guideline (MIG), capping her medical and rehabilitation benefits at $3,500.

The applicant applied to the Licence Appeal Tribunal, arguing she should be removed from the MIG due to chronic pain and pre-existing conditions.

The Tribunal found that the applicant failed to meet her burden of proving a chronic pain condition, preferring the thorough and uncontested evidence of the respondent's medical experts.

The Tribunal also found no evidence that any pre-existing conditions prevented maximal recovery within the MIG limits.

Consequently, the applicant's injuries were deemed minor, and her claims for further medical benefits and interest were dismissed.

The applicant was injured in a motor vehicle accident and sought medical and rehabilitation benefits beyond the $3,500 Minor Injury Guideline (MIG) cap, claiming chronic pain and psychological impairments.

The Licence Appeal Tribunal found that the applicant failed to meet the onus of proving entitlement beyond the cap.

The Tribunal gave little weight to the applicant's psychological evidence, which was based solely on a telephone interview, and preferred the respondent's in-person psychological assessment.

The Tribunal concluded the applicant suffered predominantly minor injuries and dismissed the appeal.