3 total
Accident benefits largely denied due to unreliable self-report and pre-existing conditions; minor treatment plans approved.
The applicant, who has pre-existing cerebral palsy, sought various statutory accident benefits following a motor vehicle accident, including $6,000 per month for attendant care, $1,000,000 for home modifications, and multiple treatment plans.
The Tribunal found the applicant's self-report to be unreliable and preferred the evidence of the respondent's assessors, concluding that the accident caused only soft tissue injuries and an adjustment disorder, not the severe physical and cognitive decline claimed.
The Tribunal denied the claims for attendant care, home modifications, and most treatment plans, but approved psychological treatment and aquatherapy as reasonable and necessary.
Claims for interest on the approved plans were granted, but the request for a special award was dismissed.
Catastrophic impairment claim denied as applicant's combined whole person impairment was assessed at 41%.
The applicant sought a determination that he sustained a catastrophic impairment following a motor vehicle accident, claiming a whole person impairment of 55% or more.
The Tribunal reviewed extensive medical evidence and expert testimony regarding the applicant's physical and psychological impairments, including gait derangement, spine impairment, traumatic brain injury, and mental/behavioural disorders.
The Tribunal concluded the applicant's combined whole person impairment was 41%, falling short of the 55% threshold.
Consequently, claims for attendant care beyond the 104-week limit were dismissed.
The Tribunal partially approved treatment plans for a chronic pain program, chiropractic spinal manipulation, and psychotherapy, subject to remaining policy limits.
Claims for a special award and costs were dismissed.
Application for accident benefits dismissed; injuries fell within the Minor Injury Guideline.
The applicant was injured in a motor vehicle accident and sought medical benefits for chiropractic treatment.
The insurer denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant failed to prove her injuries fell outside the MIG or that she had a pre-existing condition preventing maximal recovery within the MIG limit.
The Tribunal also found the proposed treatment plans were not reasonable and necessary.
The application was dismissed.
No linked lawyers found.
No linked judges found.