9 total
Application for accident benefits dismissed as injuries fell within the Minor Injury Guideline.
The applicant sought statutory accident benefits following a motor vehicle accident, claiming her physical and psychological injuries removed her from the Minor Injury Guideline (MIG).
The respondent denied the claims, relying on insurer's examinations that concluded the injuries were soft tissue in nature and fell within the MIG.
The Tribunal found that the applicant failed to provide compelling medical evidence to prove her injuries warranted treatment outside the MIG, noting that her chiropractic expert's methodology lacked proven reliability and her psychological expert relied heavily on self-reporting.
The application for benefits and interest was dismissed.
The court refused to qualify a pediatrician as an expert in child maltreatment, finding the proposed discipline lacked threshold reliability as a novel science.
The applicant child protection agency sought to qualify an expert in child maltreatment.
The court conducted a voir dire to determine the admissibility of the expert's opinion evidence.
The court found that "child maltreatment" as a general field of scientific inquiry lacked threshold reliability as a novel science, as there was no evidence of tested theories/techniques, peer review of the general discipline, or established standards for information quality.
Furthermore, the court determined that the expert was engaged for litigation purposes, not as a "participation expert" and thus failed to comply with Rule 20.2(2) of the Family Law Rules.
Consequently, the expert was not qualified, and his report was not admitted, as the risks of admitting unreliable evidence outweighed any benefit.
Application for medical benefits and transportation expenses dismissed for lack of supporting medical evidence.
The applicant sought statutory accident benefits for a digital motion x-ray exam, assessments, and transportation expenses following a motor vehicle accident.
The adjudicator found that the applicant failed to provide sufficient objective medical evidence to prove the digital x-ray and assessments were reasonable and necessary, relying instead on the respondent's insurer examinations which found no accident-related abnormalities.
The claim for transportation expenses was denied because the applicant failed to submit a required treatment plan.
The application was dismissed, and the respondent's request for costs was denied as there was no evidence of unreasonable or bad faith conduct by the applicant.
Appeal of accident benefits denial dismissed; appellant's representative ordered to personally pay $3,000 in costs.
The appellant appealed an arbitrator's decision denying her claims for income replacement benefits, medical and rehabilitation benefits, and housekeeping expenses following a motor vehicle accident.
The Director's Delegate dismissed the appeal, finding that the arbitrator's decision was well-reasoned and supported by the evidence, particularly the DAC reports which contradicted the appellant's expert.
Furthermore, the Director's Delegate ordered the appellant's representative to personally pay the respondent's appeal expenses of $3,000, finding that the representative pursued the appeal to validate an assessment method for his own personal agenda, thereby causing expenses to be incurred unreasonably.
Insurer ordered to pay for treatment plans and special awards due to procedural non-compliance.
The applicants were injured in a motor vehicle accident and sought payment for chiropractic treatment and housekeeping expenses from their insurer.
The arbitrator found the applicants' evidence regarding the necessity of the treatment and housekeeping services to be implausible and unreliable.
However, because the insurer failed to comply with the mandatory procedures under section 38(12) of the Schedule for rejecting a treatment plan, the arbitrator ordered the insurer to pay for the second treatment plans submitted by the applicants.
The arbitrator also awarded each applicant a $500 special award due to the insurer's procedural non-compliance, but denied the claims for housekeeping expenses and ordered each party to bear their own arbitration expenses.
Appeal of accident benefits decision dismissed; DMX testing expense denied as remote and unnecessary.
The appellant appealed an arbitrator's decision denying her claim for a digital motion x-ray (DMX) expense and failing to address her claim for a special award following a motor vehicle accident.
The Director's Delegate upheld the arbitrator's finding that the DMX test was not reasonable or necessary under section 24 of the Statutory Accident Benefits Schedule, as it was conducted long after treatment ceased and was too remote from any potential benefits.
The Delegate varied the order to explicitly dismiss the claim for a special award, finding no evidence of insurer misconduct to justify it.
The appeal was otherwise dismissed.
Application for accident benefits dismissed; ongoing chiropractic treatment found not reasonable or necessary.
The applicant was injured in a low-speed motor vehicle accident and sought statutory accident benefits for chiropractic and massage treatment.
The insurer refused to pay for one year of treatment, arguing it was not reasonable or necessary.
The arbitrator dismissed the application, finding the applicant's evidence of accident-related pain unreliable due to his pre-accident medical history and pre-occupation with his health.
The arbitrator rejected the opinions of the applicant's chiropractors, citing methodological flaws, deficient record-keeping, and a failure to consider the applicant's full medical history.
The arbitrator accepted expert evidence that the applicant would benefit more from cognitive therapy and an exercise program rather than ongoing passive physical therapy.
Arbitrator denies ongoing IRBs and expensive assessments, awarding only limited palliative treatment and housekeeping benefits.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including income replacement benefits (IRBs), medical benefits, housekeeping expenses, and the cost of assessments.
The arbitrator found that the applicant did not meet the test for IRBs, as medical evidence indicated she was not substantially unable to perform her work tasks.
Claims for treatment at Four Winds were denied due to unreliable invoices, while palliative treatment at Gateway was approved only up to August 2004, after which active rehabilitation should have commenced.
Housekeeping benefits were partially awarded.
Claims for expensive chiropractic assessments were denied as premature and excessive.
A claim for a special award was dismissed, but interest was awarded on overdue amounts.
Arbitrator awards partial accident benefits but denies cost of unproven digital motion x-ray diagnostic test.
The applicant sustained soft tissue injuries in a rear-end motor vehicle collision and sought statutory accident benefits, including caregiver benefits, housekeeping expenses, medical rehabilitation, and the cost of a digital motion x-ray (DMX).
The insurer denied the claims, arguing the applicant's injuries should have resolved within normal healing times.
The arbitrator found the applicant suffered a substantial inability to perform her pre-accident caregiver and heavier housekeeping duties for a limited period, awarding reduced amounts due to exaggerated claims.
The arbitrator also awarded partial medical and rehabilitation benefits, finding the applicant's pre-existing poor posture delayed her recovery beyond the standard guidelines.
The claim for the DMX test was dismissed, as the technique lacked general diagnostic approval in Canada, the expert promoting it lacked independence, and the test was conducted too remotely from the applicant's treatment period to be considered a reasonable expense.