3 total
Application for IRBs and psychological treatment dismissed as applicant failed to prove substantial inability to work and submitted non-compliant treatment plans.
The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to income replacement benefits (IRBs), psychological treatment, and assessment costs.
The adjudicator found that the applicant suffered soft tissue injuries, fractured ribs, and psychological injuries, but failed to prove a substantial inability to perform the essential tasks of his pre-accident employment after January 21, 2020.
The claims for psychological treatment were dismissed because the treatment plans did not comply with the Schedule, as they listed a psychological associate as the provider while the services were actually provided by an unsupervised psychotherapist.
The adjudicator also found the requested 1.5-hour sessions were not reasonable or necessary compared to the 1-hour sessions recommended by the respondent's assessor.
The applicant was awarded $50.39 for the cost of preparing one treatment plan due to an improper denial, with interest.
Claim for psychological treatment benefits dismissed as applicant failed to prove injuries fell outside the Minor Injury Guideline.
The applicant sought statutory accident benefits following a 2015 motor vehicle accident.
A previous Tribunal decision found the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant brought a new application claiming psychological impairments took him out of the MIG, relying on a catastrophic impairment rebuttal report from a psychiatrist.
The Tribunal assigned little weight to the applicant's psychiatric evidence due to inconsistencies with the doctor's own clinical notes and surveillance evidence showing the applicant functioning independently.
The respondent's assessors could not determine impairment levels due to the applicant's lack of credibility and cooperation.
The Tribunal concluded the applicant failed to prove his injuries fell outside the MIG, dismissing the claim for a $4,678.40 psychological treatment plan and interest.
Claim for ongoing weekly income benefits dismissed; insurer's claim for repayment of medical benefits also dismissed.
The applicant was injured while a passenger on a bus and received statutory accident benefits.
The insurer terminated weekly income benefits and supplementary medical benefits in 1995.
The applicant sought reinstatement of weekly income benefits, and the insurer sought repayment of medical benefits paid for psychological treatment.
The arbitrator found that the applicant was physically and psychologically capable of returning to work by April 1995, dismissing the claim for ongoing weekly income benefits.
The arbitrator also dismissed the insurer's claim for repayment, finding the psychological treatment received prior to termination was reasonable and beneficial.
No linked lawyers found.
No linked judges found.