3 total
Application for income replacement benefits dismissed; surveillance and medical evidence showed applicant could work.
The applicant sought income replacement benefits following a motor vehicle accident, claiming chronic pain prevented him from returning to his pre-accident work as a supervisor and interior finisher.
The respondent insurer terminated benefits after 104 weeks.
The Tribunal found that the applicant did not suffer a substantial inability to perform his pre-accident employment, relying on surveillance evidence showing him performing physical work and medical reports indicating normal functioning.
The Tribunal dismissed the application for income replacement benefits, an award for unreasonable withholding, and interest.
Arbitrator awards physical therapy benefits outside the Minor Injury Guideline due to exacerbated pre-existing conditions.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits for physical therapy and a psychological assessment.
The insurer denied the physical therapy plans, arguing the applicant's impairments were pre-existing and fell within the Minor Injury Guideline.
The arbitrator preferred the evidence of the applicant's orthopaedic surgeon, finding the accident exacerbated pre-existing degenerative conditions in the low back and right knee, warranting further physical therapy outside the Minor Injury Guideline.
Three of the four physical therapy plans were approved, while one was denied because it was retroactively altered.
The arbitrator also denied the unapproved balance for a psychological assessment, finding the services were provided by an unregulated counsellor and billed improperly.
The applicant was awarded interest on overdue benefits, and no costs were ordered.
Tribunal partially approves treatment plans, granting social service assessment but denying chiropractic and orthopaedic assessments.
The applicant sought medical and rehabilitation benefits following a motor vehicle accident.
The respondent denied treatment and assessment plans for chiropractic services, a social service assessment, and an orthopaedic assessment.
The Tribunal found that the applicant failed to prove the chiropractic services and orthopaedic assessment were reasonable and necessary, largely due to insufficient evidence and an unreliable affidavit from her chiropractor.
However, the Tribunal approved the social service assessment, finding it reasonable and necessary to address the applicant's relationship and job-related issues caused by the accident.
Interest was awarded on the overdue amount, and the respondent's request for costs was denied.
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