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Applicant deemed catastrophically impaired under Criterion 8 due to marked mental and behavioural impairments.
The applicant sought statutory accident benefits following a motor vehicle accident, claiming catastrophic impairment due to mental and behavioural disorders under Criterion 8 of the Schedule.
The Tribunal found that the applicant sustained a marked impairment in three domains of functioning: activities of daily living, adaptation, and social functioning, preferring the evidence of the applicant's psychiatrist over the respondent's.
The Tribunal concluded the applicant was catastrophically impaired.
However, the applicant's claim for a psychological services treatment plan was dismissed as he failed to provide evidence establishing it was reasonable and necessary.
Accident benefits claims dismissed as applicant's injuries fell within the Minor Injury Guideline limits.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied various treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit had been exhausted.
The applicant argued for removal from the MIG due to psychological impairment and chronic pain.
The Tribunal preferred the evidence of the insurer's assessors, finding no psychiatric diagnosis or chronic pain attributable to the accident.
The Tribunal concluded the injuries were predominantly minor, the MIG limit applied, and dismissed the claims for further treatment, interest, and an award for unreasonable delay.
Post-104 IRBs awarded as psychological impairments caused a complete inability to engage in suitable employment.
The applicant was injured in a motor vehicle accident and sought post-104 income replacement benefits (IRBs) and the cost of an attendant care assessment.
The respondent denied the benefits and sought to exclude late-served s. 44 catastrophic impairment reports.
The Tribunal admitted the reports, finding no prejudice to the respondent.
On the merits, the Tribunal found the accident was a necessary cause of the applicant's back pain and surgeries.
Relying on both the applicant's and the respondent's medical experts, the Tribunal concluded the applicant suffered significant psychological impairments, including a marked to extreme impairment in adaptation to work settings, rendering her completely unable to engage in suitable employment.
The Tribunal awarded the post-104 IRBs but denied the attendant care assessment cost due to insufficient evidence.
Catastrophic impairment designation denied; partial approval granted for disputed treatment plans and devices.
The applicant sought a catastrophic impairment designation and approval for various treatment plans following a motor vehicle accident.
The Licence Appeal Tribunal found that the applicant did not meet the threshold for catastrophic impairment, as he only demonstrated marked impairment in two of the required three areas of function (social functioning and adaptation).
The Tribunal approved several treatment plans, including occupational therapy, psychological therapy, and a mobile phone, finding them reasonable and necessary to address the applicant's accident-related impairments.
Other treatment plans, including those for optometric services and a computer, were denied.
Appeal and judicial review dismissed; LAT reasonably dismissed accident benefits application for failure to attend insurer examination.
The appellant sought to appeal and judicially review two decisions of the Licence Appeal Tribunal (LAT) regarding her application for statutory accident benefits following a motor vehicle accident.
The LAT had stayed her application and subsequently dismissed it because she refused to attend a reasonably necessary section 44 psychiatric insurer examination.
The Divisional Court heard the judicial review and appeal concurrently.
The court found the LAT's decisions were reasonable, as the insurer had made efforts to accommodate the appellant's requests for a virtual assessment with a female clinician, but the appellant still refused to attend.
Finding no error of law or breach of procedural fairness, the court dismissed both the appeal and the application for judicial review.
Applicant entitled to pre-104 week income replacement benefits for psychological impairments, but medical benefits denied.
The applicant was injured in a rear-end motor vehicle accident and sought statutory accident benefits, including income replacement benefits (IRBs) and medical benefits.
The Licence Appeal Tribunal found that the applicant's accident-related psychological condition and pain caused a substantial inability to perform the essential tasks of her pre-accident employment as a student placement coordinator, entitling her to IRBs for the pre-104 week period.
However, the Tribunal dismissed her claim for post-104 week IRBs, finding she did not suffer a complete inability to engage in suitable employment.
The Tribunal also denied the claimed medical benefits for physiotherapy, an attendant care assessment, and assistive devices, preferring the insurer's medical evidence that the physical injuries did not warrant the disputed treatment plans.
Applicant awarded partial medical and rehabilitation benefits; claims for non-earner benefits and assessments dismissed.
The applicant sought statutory accident benefits following a motor vehicle accident, including non-earner benefits, medical and rehabilitation benefits, and the cost of assessments.
The Licence Appeal Tribunal found that the applicant failed to prove a complete inability to carry on a normal life, dismissing the claim for non-earner benefits.
The Tribunal partially approved treatment plans for physiotherapy and psychological services, finding them reasonable and necessary.
Claims for chiropractic treatment, dental services, replacement eyewear, and various assessments were dismissed due to insufficient evidence or failure to prove they were reasonable and necessary as a result of the accident.