2 total
Income replacement benefits denied where ongoing impairments were caused by pre-existing conditions and a subsequent workplace injury.
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.
Claim for psychological treatment granted due to accident-related exacerbation; non-earner and chronic pain benefits denied.
The applicant sought statutory accident benefits following a motor vehicle accident, including non-earner benefits, a chronic pain program, a chronic pain assessment, and psychological counselling.
The adjudicator dismissed the claim for non-earner benefits, finding that the applicant failed to prove a complete inability to carry on a normal life, as his post-accident limitations were largely similar to his pre-accident condition.
The claims for the chronic pain program and assessment were also dismissed because the applicant had a pre-existing diagnosis of chronic pain syndrome, and the medical evidence failed to establish that the accident materially contributed to it.
However, the adjudicator granted the claim for psychological counselling, finding that the accident materially contributed to an exacerbation of the applicant's pre-existing mental health symptoms, as supported by the respondent's own psychological expert.
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