9 total
Application for non-earner benefits dismissed as applicant failed to prove complete inability to carry on normal life.
The applicant sought a non-earner benefit, interest, and an award under the Statutory Accident Benefits Schedule following a motor vehicle accident.
The Tribunal excluded late-filed evidence from the applicant due to procedural unfairness.
Applying the Heath test, the Tribunal found the applicant failed to demonstrate a complete inability to carry on a normal life, noting his completion of an educational program and return to work and daily activities.
The application was dismissed in its entirety.
Catastrophic impairment claim dismissed; applicant failed to meet WPI threshold or show marked mental impairments.
The applicant sought a determination that he sustained a catastrophic impairment following a motor vehicle accident, relying on Criteria 7 and 8 of the Statutory Accident Benefits Schedule.
The Licence Appeal Tribunal dismissed the application, finding the applicant did not meet the 55% whole-person impairment threshold under Criterion 7 or demonstrate three marked impairments under Criterion 8.
The Tribunal gave no weight to the reports of the applicant's medical experts who failed to attend the hearing for cross-examination, and preferred the evidence of the respondent's assessors, which showed only mild physical and psychological impairments.
Catastrophic impairment claim dismissed; applicant's experts given no weight for failing to attend hearing.
The applicant sought a determination that he sustained a catastrophic impairment as a result of a motor vehicle accident under Criteria 7 and 8 of the Statutory Accident Benefits Schedule.
The Tribunal weighed competing multidisciplinary expert reports.
The Tribunal gave no weight to the applicant's orthopaedic and psychiatric experts because they failed to attend the hearing for cross-examination, and found the applicant's occupational therapist's evidence unreliable due to inconsistencies with observed function.
Preferring the respondent's experts, the Tribunal found the applicant sustained a 5% physical WPI and 5% psychological WPI, failing to meet the 55% threshold under Criterion 7, and sustained only mild impairments in the spheres of functioning under Criterion 8.
The application was dismissed.
Reconsideration request denied as the applicant failed to demonstrate material errors in the catastrophic impairment assessment.
The applicant requested a reconsideration of a Licence Appeal Tribunal decision that found he was not catastrophically impaired following a motor vehicle accident.
The applicant argued that the panel erred in its assessment of medical evidence from several experts and improperly applied the AMA Guides for impairment ratings under Criteria 6, 7, and 8.
The Vice-Chair dismissed the request, finding that the applicant was attempting to re-litigate the panel's factual findings and re-weigh the evidence.
The Vice-Chair concluded that the applicant failed to demonstrate any material errors of law or fact, or breaches of procedural fairness, that would have likely changed the outcome of the original decision.
Catastrophic impairment claim dismissed as marked psychological impairments were attributed to pre-existing conditions.
The applicant sought accident benefits following a 2019 motor vehicle accident, claiming catastrophic impairment due to psychological issues.
The adjudicator first held that the applicant was barred from disputing attendant care benefits because he failed to attend scheduled insurer's examinations without a valid reason.
On the catastrophic impairment issue, the adjudicator preferred the respondent's psychiatric assessment, finding that the applicant's marked psychological impairments were attributable to extensive pre-existing conditions, including bereavement following his mother's death, rather than the subject accident.
As the applicant did not meet the catastrophic impairment threshold and his non-catastrophic limits were exhausted, the claims for disputed treatment plans were dismissed.
Application for catastrophic impairment designation dismissed as applicant failed to meet the required impairment thresholds.
The applicant sought a determination that he sustained a catastrophic impairment (CAT) following a 2020 motor vehicle accident, claiming entitlement to extended medical benefits.
The Tribunal assessed the applicant's physical and psychological impairments under Criteria 6, 7, and 8 of the Statutory Accident Benefits Schedule.
The Tribunal found insufficient evidence of radiculopathy and rejected several of the applicant's expert ratings, ultimately determining a 25% physical whole person impairment (WPI).
Combined with psychological impairments, the applicant did not meet the 55% WPI threshold.
The Tribunal also found the applicant did not suffer three marked impairments in his spheres of functioning.
As the applicant did not meet the CAT threshold and the non-CAT limits were exhausted, the application for medical benefits, an award, and interest was dismissed.
Catastrophic impairment designation denied; psychological and occupational therapy treatment plans approved as reasonable and necessary.
The applicant sought a determination of catastrophic impairment and entitlement to various medical, rehabilitation, and transportation benefits following a motor vehicle accident.
The Licence Appeal Tribunal found that the applicant did not sustain a catastrophic impairment under either Criterion 7 (55% Whole Person Impairment) or Criterion 8 (mental or behavioural disorder), preferring the respondent's medical evidence which indicated lower impairment ratings.
However, the Tribunal granted the applicant's claims for a psychological treatment plan and an occupational therapy assessment, finding them reasonable and necessary.
The claims for transportation expenses were dismissed for lack of evidence.
Reconsideration requests from both parties dismissed; no errors of law or procedural fairness breaches found.
Both the applicant and the respondent requested reconsideration of a Licence Appeal Tribunal decision regarding statutory accident benefits.
The respondent argued the adjudicator erred in law by not including language about post-accident income deductions in the income replacement benefit order.
The applicant argued the adjudicator breached procedural fairness and erred in law by admitting a medical report without the author being available for cross-examination, refusing to issue summonses, and failing to provide adequate reasons regarding catastrophic impairment.
The Tribunal dismissed both requests, finding no errors of law, fact, or breaches of procedural fairness that would have changed the outcome.
The respondent's request for costs was also dismissed.
Application for accident benefits dismissed; injuries fell within Minor Injury Guideline and non-earner benefit denied.
The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to treatment beyond the Minor Injury Guideline (MIG) and a non-earner benefit.
The Licence Appeal Tribunal found that the applicant failed to demonstrate that his chronic pain, psychological impairments, or pre-existing conditions warranted removal from the MIG.
As the MIG limits were exhausted, the disputed treatment plan for physiotherapy was not payable.
The Tribunal also dismissed the claim for a non-earner benefit, finding insufficient evidence to establish that the applicant suffered a complete inability to carry on a normal life.
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