56 total
Applicant removed from Minor Injury Guideline due to chronic pain and awarded disputed treatment plans.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied several treatment and assessment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant suffered from chronic pain with functional impairments, removing her from the MIG.
The Tribunal ordered the respondent to pay for the disputed physiotherapy, psychological, and chronic pain treatment plans, finding them reasonable and necessary.
The applicant's claim for a special award for unreasonable delay was dismissed, but interest on overdue benefits was granted.
Applicant's claim for removal from the Minor Injury Guideline dismissed due to lack of objective psychological evidence.
The applicant sought statutory accident benefits following a motor vehicle accident, claiming that his psychological injuries warranted removal from the Minor Injury Guideline (MIG).
The respondent denied the treatment plans, arguing the injuries were predominantly minor.
The adjudicator preferred the respondent's psychological assessment, which found no clinically significant psychological condition, over the applicant's expert, whose diagnoses were not supported by objective psychometric testing.
The adjudicator concluded the applicant's injuries fell within the MIG, dismissing the claims for treatment plans, interest, and an award for unreasonable delay.
Application for accident benefits dismissed; injuries fell within the Minor Injury Guideline and non-earner benefits denied.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including non-earner benefits and various treatment plans.
The respondent denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Licence Appeal Tribunal found that the applicant failed to provide sufficient objective medical evidence to prove that she suffered from chronic pain or psychological impairments warranting removal from the MIG.
The Tribunal also dismissed the claim for non-earner benefits, finding that the applicant continued to work and engage in her pre-accident activities, and therefore did not suffer a complete inability to carry on a normal life.
The application was dismissed in its entirety.
Application for accident benefits dismissed; applicant failed to prove injuries warranted removal from MIG.
The respondent denied various treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant argued that pre-existing conditions, chronic pain, and psychological impairments warranted removal from the MIG.
The Tribunal found that the applicant failed to provide compelling medical evidence to establish that his pre-existing conditions prevented maximal recovery within the MIG, or that he suffered from chronic pain with functional impairment or a psychological impairment.
As the applicant remained subject to the MIG, the disputed treatment plans were not payable.
The application was dismissed.
Application for accident benefits dismissed; applicant failed to prove injuries warranted removal from the Minor Injury Guideline.
The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant argued for removal from the MIG based on psychological injuries and a pre-existing anxiety condition.
The Tribunal found the applicant failed to establish on a balance of probabilities that he suffered from accident-related psychological injuries warranting removal, giving little weight to the applicant's psychological and chiropractic evidence.
The Tribunal also found insufficient medical evidence that a pre-existing condition precluded his recovery within the MIG.
Applicant denied non-earner benefit but awarded partial entitlement to treatment plans and $500 in costs.
The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit and several treatment plans.
The Tribunal found the applicant was not entitled to the non-earner benefit, as he continued to work full-time and did not suffer a complete inability to carry on a normal life.
The Tribunal allowed some of the disputed treatment plans, including physiotherapy, an in-home assessment, and a chronic pain assessment, finding them reasonable and necessary.
Other treatment plans were denied, and the Tribunal rejected the applicant's arguments that they were payable due to defective denial notices under s. 38(11).
The Tribunal awarded the applicant $500 in costs due to the respondent's unreasonable failure to comply with production orders.
Application for accident benefits dismissed as applicant failed to prove injuries fell outside the Minor Injury Guideline.
The applicant sought statutory accident benefits following a 2017 motor vehicle accident.
The Tribunal found that the applicant failed to prove her psychological and chronic pain impairments were caused by the 2017 accident, noting a failure by her medical assessors to account for a prior 2014 accident.
The application for treatment plans, an award for unreasonable delay, and interest was dismissed.
Application for accident benefits dismissed; applicant failed to prove entitlement to MIG removal or non-earner benefits.
The applicant sought statutory accident benefits following a motor vehicle accident, disputing the insurer's determination that her injuries fell within the Minor Injury Guideline (MIG).
The applicant claimed entitlement to a non-earner benefit, various treatment plans, and removal from the MIG due to pre-existing conditions, psychological impairments, and chronic pain syndrome.
The Licence Appeal Tribunal found that the applicant failed to establish that her pre-existing conditions precluded recovery within the MIG, nor did she prove accident-related psychological impairments or chronic pain syndrome.
The Tribunal also dismissed the claim for a non-earner benefit, finding insufficient evidence of a complete inability to carry on a normal life.
As the applicant remained in the MIG and the limits were exhausted, the disputed treatment plans were denied.
Application for chronic pain assessment dismissed due to insufficient corroborating medical evidence of impairment.
The applicant sought payment for a chronic pain assessment following a 2019 motor vehicle accident.
The Licence Appeal Tribunal found that the applicant failed to provide sufficient medical evidence, such as contemporaneous complaints to her family doctor, to establish grounds for the assessment.
The Tribunal dismissed the application, denying the treatment plan, interest, and a claim for a special award.
Application for accident benefits dismissed as injuries fell within the Minor Injury Guideline.
The applicant argued for removal from the MIG based on chronic pain, post-concussion syndrome, and psychological impairments.
The Tribunal found the applicant failed to establish on a balance of probabilities that she suffered from any of these conditions, noting a lack of supporting medical evidence and preferring the respondent's expert reports.
The application for psychological services and interest was dismissed.
Application for accident benefits dismissed; injuries found to be predominantly minor and subject to MIG.
The applicant claimed removal from the MIG based on psychological impairment and chronic pain.
The Tribunal found the applicant failed to prove on a balance of probabilities that he suffered from a psychological impairment or chronic pain with functional impairment caused by the accident.
The medical evidence indicated soft tissue injuries and the applicant maintained an active lifestyle.
The application was dismissed, and the applicant was not entitled to the disputed treatment plans, an award, or interest.
The respondent denied various treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant claimed removal from the MIG based on chronic pain and psychological impairments.
The Tribunal found the applicant did not meet the burden of proof for removal, noting his return to pre-accident work and activities, and the lack of supporting documentation from treating physicians.
The application for disputed treatment plans, interest, and an award was dismissed.
Applicant removed from MIG for psychological injuries but denied higher hourly rate for qualifying psychotherapist.
The Tribunal found that the applicant's psychological impairments, including anxiety and specific phobias, warranted removal from the Minor Injury Guideline (MIG).
However, the Tribunal dismissed the claims for outstanding balances on psychological treatment plans, finding that the provider was a qualifying psychotherapist and not entitled to the higher hourly rate reserved for psychologists under the Professional Services Guideline.
Application for accident benefits dismissed; injuries found to be predominantly minor and subject to the MIG.
The applicant sought statutory accident benefits following a motor vehicle accident, arguing his injuries fell outside the Minor Injury Guideline (MIG) due to psychological impairments and chronic pain.
The Licence Appeal Tribunal found the applicant failed to prove a psychological impairment, preferring the respondent's psychological assessment which aligned with the family physician's records.
The Tribunal also found the applicant did not establish chronic pain with functional limitations, noting he met at most one of the six criteria under the AMA Guides.
As the injuries were predominantly minor, the applicant was not entitled to the disputed treatment plans, an award, interest, or costs.
Application for accident benefits dismissed as applicant failed to prove chronic pain syndrome or need for treatment.
The applicant sought statutory accident benefits for a multidisciplinary chronic pain treatment program and chiropractic services following a motor vehicle accident.
The insurer denied the benefits.
The Licence Appeal Tribunal found that the applicant failed to prove on a balance of probabilities that he suffered from chronic pain syndrome or that the proposed treatment plans were reasonable and necessary.
The Tribunal noted a lack of objective medical evidence and found that the applicant did not meet the criteria for chronic pain under the AMA Guides.
Applicant's injuries found to be minor; removal from Minor Injury Guideline denied.
The respondent denied several 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 predominantly minor and that he failed to provide compelling medical evidence of a pre-existing condition, chronic pain with functional impairment, or a psychological impairment that would warrant removal from the MIG.
As the applicant remained subject to the $3,500 MIG limit, the disputed treatment plans were not payable and no interest was owed.
The applicant sought accident benefits following a motor vehicle accident, arguing his injuries warranted removal from the Minor Injury Guideline (MIG) due to pre-existing conditions, chronic pain, and psychological impairments.
The Tribunal found that the applicant's pre-existing degenerative disc disease did not preclude his recovery within the MIG.
Furthermore, the applicant failed to meet the AMA criteria for chronic pain and lacked evidence of psychological complaints to treating professionals.
As the applicant remained within the MIG and the treatment limit was exhausted, the disputed treatment plans and interest were denied.
The respondent's request for costs was also dismissed.
The court granted default judgment to an insurer, finding its $300,000 settlement with the injured plaintiff reasonable.
This motion for default judgment was brought by Security National Insurance Company, as assignee of the plaintiff, against the at-fault operator, Anthony Williams, following a motor vehicle accident.
Williams had been noted in default.
The court assessed liability and damages, finding Williams liable and the $300,000 settlement paid by Security National to the plaintiff to be fair and reasonable compensation for her injuries, which included chronic pain and psychological issues meeting the Insurance Act threshold.
Default judgment was granted against Williams, along with costs.
Applicant failed to prove psychological impairment or chronic pain to escape the Minor Injury Guideline.
The applicant sought accident benefits following a motor vehicle accident, claiming removal from the Minor Injury Guideline (MIG) due to psychological impairment and chronic pain.
The Licence Appeal Tribunal found the applicant's evidence insufficient to establish a psychological condition or chronic pain with functional impairment, preferring the respondent's psychological assessment.
The Tribunal held that the applicant's injuries were predominantly minor, limiting her entitlement to the remaining $68.00 of the $3,500 MIG limit, and dismissed claims for further medical benefits and a special award.
Psychological services approved as reasonable and necessary; accountant's report denied for lack of evidence.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits for psychological services and an accountant's report.
The Tribunal found the psychological services were reasonable and necessary to treat the applicant's adjustment disorder and specific phobia, noting the treating psychologist's recommendations and the applicant's progress.
However, the Tribunal denied the cost of the accountant's report because the applicant failed to prove he was applying for an income replacement benefit or that the report was reasonable and necessary.
The applicant was awarded the cost of the psychological services with interest.