9 total
Reconsideration granted in part to approve a previously unaddressed physiotherapy treatment plan.
The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied several treatment plans and a claim for an award under the Statutory Accident Benefits Schedule.
The Tribunal dismissed the reconsideration request regarding the award, the psychological assessment, and a chiropractic treatment plan, finding no errors of law or fact that would have changed the outcome.
However, the Tribunal granted the reconsideration in part, finding it had erred by failing to explicitly address a physiotherapy treatment plan dated August 14, 2023.
The Tribunal varied its original decision to approve the physiotherapy plan, noting it was supported by a contemporaneous chronic pain assessment.
Application for accident benefits dismissed; injuries found to fall within the Minor Injury Guideline.
The applicant sought accident benefits following a motor vehicle accident, arguing her injuries warranted removal from the Minor Injury Guideline (MIG) due to pre-existing conditions, psychological impairment, and chronic pain.
She also claimed entitlement to non-earner benefits and two treatment plans.
The Tribunal found the applicant's evidence insufficient to establish that her pre-existing conditions prevented recovery within the MIG.
The Tribunal preferred the respondent's expert evidence, concluding the applicant sustained only minor soft tissue injuries and no diagnoseable psychological impairment.
The claims for non-earner benefits and treatment plans outside the MIG limit were dismissed.
Application for accident benefits dismissed; applicant failed to establish impairments warranting removal from MIG.
The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to psychological assessments and treatment outside the Minor Injury Guideline (MIG).
The applicant argued for removal from the MIG based on psychological impairments and chronic pain.
The Tribunal found the applicant's evidence insufficient, preferring the respondent's psychological assessments which found only subclinical symptoms.
The Tribunal also found the applicant did not meet the criteria for chronic pain.
The application was dismissed, with the applicant remaining subject to the $3,500 MIG limit.
Application for accident benefits dismissed as injuries fell within the Minor Injury Guideline.
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) and the $3,500 funding limit had been exhausted.
The applicant claimed removal from the MIG was warranted due to psychological injuries, chronic pain, and a pre-existing right knee condition.
The Tribunal found the applicant failed to meet his burden of demonstrating his injuries fell outside the MIG.
The Tribunal preferred the respondent's psychological assessment over the applicant's, found no objective evidence of chronic pain, and concluded the pre-existing knee condition did not preclude recovery from the accident-related injuries.
The application was dismissed.
Application for accident benefits dismissed; applicant failed to prove injuries fell outside the Minor Injury Guideline.
The applicant was injured in a rear-end motor vehicle collision and sought statutory accident benefits, including a chiropractic treatment plan.
The insurer denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Licence Appeal Tribunal found that the applicant's physical injuries were minor and that she failed to provide compelling evidence of a psychological impairment or that her pre-existing conditions would prevent maximal recovery under the MIG limit.
As the MIG limits were exhausted, the application for the treatment plan and interest was dismissed.
Income replacement benefit denied due to lack of causation for cardiac issues; most treatment plans approved.
The applicant sought entitlement to an income replacement benefit and several treatment and assessment plans following a motor vehicle accident.
The respondent denied the income replacement benefit, arguing that the applicant's inability to work was due to congestive heart failure, a stroke, and cardiac arrhythmia that were not caused by the accident.
The adjudicator applied the 'but for' test and found that the applicant failed to establish a causal link between the accident and his subsequent cardiac and neurological conditions.
Consequently, the claim for an income replacement benefit was dismissed.
However, the adjudicator found that the applicant was entitled to medical benefits for chiropractic and psychological services, as well as the cost of an attendant care assessment, because these were reasonable and necessary to treat accident-related impairments.
A treatment plan for other goods and services was denied.
Application for non-earner benefit dismissed; surveillance evidence contradicted claims of complete inability to carry on normal life.
The applicant sought a non-earner benefit following a motor vehicle accident, claiming a complete inability to carry on a normal life due to physical and psychological injuries.
The Licence Appeal Tribunal dismissed the application, finding the applicant's evidence lacked specificity and was contradicted by inconsistent self-reporting and surveillance evidence showing him jet skiing and lifting weights.
The Tribunal preferred the respondent's assessments, concluding the applicant failed to meet the stringent threshold for the benefit.
Applicant denied income replacement benefit and most treatment plans, but awarded one chiropractic treatment plan.
The applicant was injured in a motor vehicle accident and sought an income replacement benefit (IRB) and various medical and rehabilitation benefits from the respondent insurer.
The insurer terminated the IRB and denied several treatment plans on the basis that the applicant no longer suffered a substantial inability to perform his pre-accident job tasks and that the treatments were not reasonable and necessary.
The Tribunal found that the applicant failed to prove a substantial inability to perform his employment tasks during the disputed period, relying on the insurer's expert assessments.
The Tribunal approved one chiropractic treatment plan as reasonable and necessary, noting the applicant's ongoing pain and the insurer's failure to conduct a timely examination, but denied the remaining plans for chiropractic, psychological, and occupational therapy services due to a lack of corroborating medical evidence.
The mother's motion for leave to bring a status review application was dismissed due to her submission of fraudulent evidence and continued breach of court orders.
A mother sought leave to bring a status review application to regain custody of two children (ages 6 and 4) who were made Crown wards without access in November 2015 following a 12-day trial.
The children had been in continuous foster care for nearly four years.
The mother claimed significant personal changes including separation from the father, completion of parenting courses, psychological assessment showing insight, and improved independence.
However, the court found the mother's credibility was severely compromised by her submission of a fraudulent airline ticket to deny violating the no-access order, her continued involvement with the father despite claims of separation, and her pattern of deception consistent with her trial conduct.
The court dismissed the motion for leave, finding the mother had not established a prima facie case for relief and remained ungovernable.