Dr. Hien Ta

The applicant sought a post-104-week income replacement benefit (IRB) following a motor vehicle accident, which the respondent insurer denied.

The Tribunal found that the applicant suffers a complete inability to engage in any employment for which she is reasonably suited by education, training, or experience, primarily due to chronic pain syndrome and psychological impairments.

The Tribunal preferred the evidence of the applicant's expert assessors over the respondent's assessors, noting that the alternate employment roles proposed by the respondent were not comparable in status or wages.

The applicant was awarded the IRB and interest on overdue payments, but her claim for a special award under section 10 of Regulation 664 was dismissed as the insurer's conduct was not found to be unreasonable or vexatious.

The applicant sought a determination of catastrophic impairment and various medical, rehabilitation, and attendant care benefits following a 2016 motor vehicle accident.

The Licence Appeal Tribunal found that the applicant did not meet the threshold for catastrophic impairment under either Criterion 7 (55% whole person impairment) or Criterion 8 (marked impairment due to mental or behavioural disorder).

The Tribunal preferred the evidence of the respondent's assessors, finding the applicant's impairments were primarily physical and did not significantly impede her useful functioning.

Claims for attendant care, occupational therapy, and physiotherapy were dismissed as not reasonable and necessary, while a small claim for prescription medication was allowed with interest.

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

The insurer denied treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant suffered from accident-related psychological impairments, including PTSD and depression, which removed her from the MIG.

The Tribunal ordered the insurer to pay for the disputed physiotherapy services and a psychological assessment, finding them reasonable and necessary.

The applicant was also awarded interest on overdue payments.

However, the Tribunal dismissed the applicant's claims for a special award under s. 10 of Regulation 664 and for costs, finding the insurer's conduct did not meet the high threshold of bad faith or unreasonableness.

The applicant sought statutory accident benefits following a 2019 motor vehicle accident.

The respondent denied several treatment plans and income replacement benefits (IRBs), arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found the applicant's chronic pain condition, supported by her family physician's records and a pain consultant's report, warranted removal from the MIG.

The Tribunal approved two physiotherapy treatment plans and one psychological assessment as reasonable and necessary.

However, the Tribunal denied a functional abilities assessment and a second psychological assessment due to a lack of submissions.

The Tribunal also denied post-104 IRBs, finding the applicant failed to demonstrate a complete inability to engage in any employment for which she was suited.

The applicant sought statutory accident benefits following a motor vehicle accident, including attendant care benefits, a non-earner benefit, and several treatment and assessment plans.

The respondent insurer denied the benefits.

The Tribunal found that the applicant failed to prove entitlement to attendant care benefits, as her self-reported resumption of daily activities contradicted the assessed needs.

The Tribunal also dismissed the claim for a non-earner benefit, finding the applicant did not suffer a complete inability to carry on a normal life, given her ability to continue nursing studies, drive, and perform household tasks.

Finally, the Tribunal denied the disputed treatment and assessment plans, preferring the respondent's medical evidence that the applicant's injuries were minor and did not require the proposed interventions.

The application was dismissed in its entirety.

The applicant sought statutory accident benefits following a motor vehicle accident, including attendant care benefits and several treatment plans for occupational therapy, physiotherapy, and a chronic pain assessment.

The adjudicator dismissed the application in its entirety.

The adjudicator preferred the respondent's section 44 assessments over the applicant's evidence, finding the applicant's occupational therapy report to be of limited evidentiary value due to inconsistencies with clinical notes and records.

Furthermore, the applicant failed to meet her evidentiary burden for the treatment plans by not providing copies of the disputed OCF-18s or specific submissions addressing the goals and costs of the proposed treatments.

The applicant sought medical benefits following a motor vehicle accident.

The respondent insurer denied the claims on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 funding limit had been exhausted.

The applicant argued that pre-existing conditions, psychological injuries, and chronic pain warranted removal from the MIG.

The Licence Appeal Tribunal found that the applicant failed to provide compelling medical evidence of a pre-existing condition that would prevent maximal recovery within the MIG.

The Tribunal also determined that the applicant's psychological symptoms and pain complaints were clinically associated sequelae of his minor soft tissue injuries.

Although the respondent failed to provide timely notice of denial for one treatment plan, barring it from relying on the MIG for that specific plan, the Tribunal found the treatment was not reasonable and necessary.

The application was dismissed.

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

The respondent insurer determined the injuries fell within the Minor Injury Guideline (MIG) and denied treatment plans exceeding the $3,500 limit.

The applicant argued he should be removed from the MIG due to a diagnosis of chronic pain syndrome.

The Tribunal found the applicant's evidence, including an expert report diagnosing chronic pain, lacked sufficient analysis and objective support.

The Tribunal concluded the applicant sustained minor soft tissue injuries and an aggravation of pre-existing degenerative changes, which did not warrant removal from the MIG.

As the MIG limits were exhausted, the disputed treatment plans and assessment were dismissed.