3 total
Application for catastrophic impairment designation and medical benefits dismissed.
The applicant sought a determination that she sustained a catastrophic impairment (Criterion 8) due to psychological impairments following a motor vehicle accident, as well as entitlement to a treatment plan for optometric services.
The Tribunal found that while the applicant had marked impairments in Concentration, Persistence and Pace, and Adaptation, she did not meet the threshold of three marked impairments or one extreme impairment required for catastrophic designation.
The Tribunal also dismissed the claim for optometric services, preferring the respondent's ophthalmological assessment that found no accident-related ocular sequelae over the applicant's neuro-optometrist report.
The application was dismissed in its entirety.
Application for accident benefits dismissed as treatment plans were not proven reasonable and necessary.
The applicant sought entitlement to statutory accident benefits for a neuro-optometric assessment and occupational therapy services following a motor vehicle accident.
The respondent denied the treatment plans, relying on insurer's examinations which concluded the applicant's ongoing symptoms were related to pre-existing conditions rather than the accident.
The Tribunal found the applicant failed to meet her burden of proving the treatment plans were reasonable and necessary, noting a lack of corroborating medical evidence and significant pre-existing health issues.
The application was dismissed.
Applicant's injuries held subject to Minor Injury Guideline; claims for additional medical benefits dismissed.
The applicant sought statutory accident benefits following a motor vehicle accident.
The applicant brought motions to admit late medical reports, which the Tribunal denied due to non-compliance with disclosure rules without sufficient explanation.
The respondent's request for costs regarding the motions was also denied.
On the substantive issues, the applicant argued his injuries should be excluded from the Minor Injury Guideline (MIG) due to a pre-existing bicep tear, chronic pain, and a concussion.
The Tribunal found the applicant failed to provide compelling medical evidence that his pre-existing condition prevented maximal recovery within the MIG limits.
The Tribunal also found the applicant did not meet the AMA Guides criteria for chronic pain and that his concussion-like symptoms were attributable to pre-existing vision issues rather than the accident.
Consequently, the applicant's injuries were deemed subject to the MIG, and his claims for additional medical benefits and interest were dismissed.
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