Dr. I. Wilderman

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

The respondent classified the applicant's injuries as minor and subject to the Minor Injury Guideline (MIG) and its $3,500 funding limit, denying several treatment and assessment plans.

The applicant argued she suffered from chronic pain and psychological injuries outside the MIG.

The Tribunal found the applicant's physical injuries were minor and her ongoing pain was related to a pre-existing condition (polymyalgia rheumatica), not the accident.

The Tribunal preferred the respondent's medical experts over the applicant's assessor, concluding the applicant did not sustain accident-related chronic pain or psychological impairments.

The application was dismissed, and no interest or award was granted.

The applicant was involved in a rear-end motor vehicle accident and sought statutory accident benefits, including income replacement benefits (IRBs) and various medical and rehabilitation benefits.

The respondent insurer denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and its $3,500 funding limit.

The Tribunal found that the applicant sustained predominantly minor injuries (soft tissue sprains/strains) and failed to prove that pre-existing conditions, neurological issues, psychological injuries, or chronic pain warranted removal from the MIG.

The Tribunal also found the applicant failed to demonstrate a substantial inability to perform the essential tasks of his pre-accident employment, denying the claim for IRBs.

The application was dismissed in its entirety.

The applicant sought statutory accident benefits following a motor vehicle accident, arguing her injuries fell outside the Minor Injury Guideline (MIG) due to chronic pain and psychological impairments.

The Tribunal found that the applicant's injuries were predominantly minor and subject to the $3,500 MIG limit.

Relying on the respondent's expert assessments, which included validity testing indicating symptom magnification, the Tribunal concluded the applicant did not suffer from a psychological impairment or chronic pain syndrome.

The Tribunal approved two physiotherapy treatment plans and prescription expenses as reasonable and necessary within the MIG limit, but denied a third physiotherapy plan, a psychological assessment, and a chronic pain assessment.

Claims for an award for unreasonable delay were dismissed, though interest was awarded on the approved benefits.

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

The respondent insurer denied portions of treatment plans for chiropractic and physiotherapy, as well as a chronic pain assessment.

The Tribunal found that the respondent failed to provide a proper denial with medical and other reasons for the first treatment plan, triggering the consequences of s. 38(11) of the Schedule.

For the remaining treatment plan and assessment, the Tribunal preferred the applicant's medical evidence, finding the respondent's independent medical examination contained internal contradictions.

The Tribunal concluded the treatment and assessment were reasonable and necessary, ordering the respondent to pay the disputed amounts plus interest.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for a functional cognitive test battery and a chronic pain assessment, which the respondent insurer denied.

The Licence Appeal Tribunal found that the applicant's pre-existing chronic pain was exacerbated by the accident, making the chronic pain assessment reasonable and necessary.

However, the Tribunal denied the functional cognitive test battery, finding no evidence of a cognitive deficit unrelated to the applicant's psychological impairments.

The Tribunal also denied the applicant's request for an award under Regulation 664, as the insurer's reliance on its independent medical examinations was not unreasonable.

The applicant was injured while riding a public bus and sought statutory accident benefits, including non-earner benefits, catastrophic impairment assessments, and various medical and rehabilitation benefits.

The Licence Appeal Tribunal found that the applicant did not suffer a complete inability to carry on a normal life, dismissing the claim for non-earner benefits.

However, given the applicant's significant pre-existing conditions and accident-related physical and psychological injuries, the Tribunal found the catastrophic impairment assessments reasonable and necessary, excluding a file review fee.

The Tribunal also approved a neurological assessment and a psychological treatment plan, while dismissing the remaining treatment plans.

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

The respondent insurer deemed the injuries to fall within the Minor Injury Guideline (MIG), capping benefits at $3,500.

The applicant argued she suffered from chronic pain and psychological injuries that removed her from the MIG.

The Tribunal found the applicant's medical evidence unpersuasive, noting methodological flaws in her expert's chronic pain diagnosis and a lack of psychological testing.

Preferring the respondent's multidisciplinary assessments, the Tribunal concluded the applicant's injuries were predominantly minor and subject to the MIG limit.

The appeal was denied.

The applicant was injured in a motor vehicle accident and sought medical benefits for physiotherapy.

The respondent denied the claim, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) limit of $3,500.

The applicant argued for removal from the MIG due to pre-existing cervical disc disease, chronic pain, and psychological impairment.

The Tribunal found that the applicant's injuries were predominantly minor, noting that his post-accident shoulder and neck issues were likely related to his pre-existing degenerative disc disease and bodybuilding routine rather than the accident.

The Tribunal afforded little weight to the applicant's chronic pain assessment as it failed to address his workout routine.

Consequently, the applicant was not removed from the MIG, and the claim for $3,030.78 in physiotherapy services was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to a physiatry assessment, assistive devices, and physiotherapy.

The respondent insurer denied the benefits, relying on insurer's examinations which concluded the applicant had reached maximum medical recovery from minor soft tissue injuries.

The adjudicator found that the applicant failed to prove the claimed benefits were reasonable and necessary, preferring the detailed analysis of the insurer's experts over the applicant's medical evidence.

The appeal was dismissed and no benefits or interest were awarded.

The applicant sought income replacement benefits (IRBs) and the cost of examinations following a minor rear-end motor vehicle accident.

The respondent insurer terminated IRBs after the applicant returned to work, arguing that her subsequent periods off work were due to pre-existing conditions, a shortage of work, and a subsequent work-related injury.

The Tribunal applied the "but for" test for causation and found that the applicant's ongoing impairments were not caused by the accident.

The Tribunal noted significant credibility issues, as the applicant provided inaccurate histories to her medical assessors regarding her prior neck pain and subsequent workplace injury.

The Tribunal preferred the evidence of the respondent's experts and concluded the applicant did not meet the tests for substantial inability or complete inability to work.

The claims for IRBs, an accounting report, a special award, and costs were dismissed, though the applicant was awarded $200 for a disability certificate.

The applicant sought statutory accident benefits following a rear-end motor vehicle collision.

The respondent denied certain treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant's injuries were minor and subject to the MIG funding limit, preferring the evidence of the respondent's assessors over the applicant's assessor, whose opinion relied heavily on self-reporting without objective validation.

The disputed treatment plans, special award, and costs were denied due to a lack of supporting evidence.