4 total
Chronic pain assessment approved but chiropractic services denied for lack of medical support.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied treatment plans for a chronic pain assessment and chiropractic services.
The Tribunal found the chronic pain assessment reasonable and necessary, noting the applicant's persistent pain complaints and the lack of treatment while incarcerated.
The Tribunal gave limited weight to the respondent's medical examination report due to its lack of analysis and failure to review treating physician records.
However, the Tribunal denied the chiropractic services plan as it lacked support from the applicant's treating practitioners.
The claim for an award under s. 10 of Reg. 664 was dismissed as no submissions were provided.
Application for non-earner benefits and physiotherapy dismissed as applicant maintained normal daily functioning.
The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to a non-earner benefit, a physiotherapy treatment plan, interest, and an award for unreasonable delay.
The adjudicator found that the applicant failed to demonstrate a complete inability to carry on a normal life, as medical assessments indicated he remained independent in his daily activities, including driving, working, and exercising.
Furthermore, the applicant did not prove the physiotherapy treatment plan was reasonable and necessary, as his own treating surgeon recommended exercise rather than physiotherapy.
The application was dismissed in its entirety.
Applicant awarded medical benefits and assessment costs; preliminary objection for non-attendance at examinations dismissed.
The respondent insurer raised a preliminary issue, arguing the applicant was barred from proceeding under s. 55 of the Schedule for failing to attend insurer's examinations.
The Tribunal found the applicant made himself reasonably available and was not barred.
On the substantive issues, the Tribunal found the accident directly caused the applicant's physical and psychological impairments.
The Tribunal granted entitlement to the disputed physiotherapy, chiropractic treatment, and an occupational therapy in-home assessment, finding them reasonable and necessary.
The claim for psychological treatment was dismissed due to lack of evidence that the applicant utilized previously approved treatment.
The Tribunal declined to order an award under Regulation 664, finding the insurer's conduct did not rise to the requisite level of unreasonableness.
Accident benefits denied where applicant failed to prove impairments were caused by the collision.
The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to caregiver, housekeeping, and medical benefits.
The insurer denied the claims on the basis that the applicant's impairments were not caused by the accident.
The arbitrator found that the applicant failed to disclose pre-existing neck and shoulder complaints to his treating practitioners and assessors, and did not report the accident to his family doctor for several months.
The arbitrator concluded that the applicant's impairments were likely caused by pre-existing pathology and the physical strain of caring for his ailing wife, rather than the accident.
The claims were dismissed, save for a small outstanding balance on a previously approved treatment plan.
No linked lawyers found.
No linked judges found.