2 total
Application for accident benefits dismissed; applicant failed to prove pre-existing condition warranted removal from Minor Injury Guideline.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied several chiropractic treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant argued that a pre-existing disc herniation should remove him from the MIG.
The Tribunal found that the applicant failed to provide compelling medical evidence that his pre-existing condition would prevent him from achieving maximum medical recovery within the MIG limit.
The Tribunal accepted the respondent's insurer examination reports, which concluded the injuries were minor soft tissue injuries.
The application was dismissed as the MIG limit had been exhausted.
Application for chronic pain assessment dismissed; insurer's denial notices complied with s. 38 of the Schedule.
The applicant sought payment for a $2,000 chronic pain assessment following a motor vehicle accident.
The respondent denied the claim, arguing the applicant's injuries fell within the Minor Injury Guideline.
The applicant challenged the sufficiency of the respondent's denial notices under s. 38 of the Statutory Accident Benefits Schedule.
The Tribunal found that the respondent's explanations of benefits complied with s. 38.
On the merits, the Tribunal held that the applicant failed to prove the chronic pain assessment was reasonable and necessary, noting evidence of steady improvement, return to pre-accident activities, and failure to pursue approved treatments.
The application was dismissed, with no interest or costs awarded.
No linked lawyers found.
No linked judges found.
