Dr. Lau

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit and several treatment plans.

The Licence Appeal Tribunal dismissed the claim for the non-earner benefit, finding the applicant failed to prove a complete inability to carry on a normal life, largely due to unreliable self-reporting and significant pre-existing conditions.

The Tribunal also dismissed claims for a neurological assessment and psychological services as not reasonable and necessary.

However, the Tribunal ordered the respondent to pay for a chronic pain assessment because the respondent's denial notices were confusing and failed to comply with section 38(8) of the Schedule.

The applicant sought statutory accident benefits following a motor vehicle accident, arguing his injuries fell outside the Minor Injury Guideline (MIG) due to a pre-existing condition, chronic pain, and psychological impairment.

The Licence Appeal Tribunal found the applicant failed to meet his onus.

The medical evidence did not establish that his pre-existing back and neck pain would prevent maximal recovery within the MIG.

Furthermore, the evidence did not support a diagnosis of chronic pain with functional impairment or a psychological impairment caused by the accident.

As the applicant's injuries were predominantly minor, he was not entitled to the disputed treatment plans which exceeded the remaining MIG limit, nor was he entitled to interest.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and that the dispute for certain treatment plans was time-barred.

The Tribunal found the limitation period was not triggered because the respondent's denial notices were procedurally non-compliant.

While the applicant failed to prove her injuries warranted removal from the MIG, the Tribunal awarded two physiotherapy treatment plans and a limited period of non-earner benefits solely due to the respondent's failure to provide compliant notices under the Schedule.

Claims for an award and remaining benefits were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent denied certain psychological treatment and assessment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant contended that pre-existing back pain and accident-related psychological impairments and chronic pain removed her from the MIG.

The Tribunal found insufficient medical evidence to support the applicant's claims, noting her family physician's records did not substantiate a pre-existing condition or a psychological diagnosis.

The Tribunal preferred the respondent's psychological expert over the applicant's, concluding the injuries were predominantly minor and the disputed treatment plans were not reasonable and necessary.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent denied further benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found the applicant suffered a fractured sternum and psychological impairments, removing him from the MIG.

The Tribunal awarded income replacement benefits, attendant care benefits, and certain medical/assessment costs.

Furthermore, the Tribunal granted a special award of 40% of the outstanding attendant care benefits, finding the respondent unreasonably withheld payment by intentionally misrepresenting its assessors' findings to keep the applicant within the MIG.

The applicants, a mother and son, sought statutory accident benefits following a motor vehicle accident.

The mother claimed caregiver, housekeeping, and medical benefits, while the son claimed income replacement and medical benefits.

The arbitrator dismissed all claims, finding severe credibility issues with both applicants' evidence.

The mother's testimony regarding the children she cared for, her residential address, and her employment of a caregiver was riddled with inconsistencies and contradicted by documentary evidence.

The son's evidence regarding his pre-accident employment and income was also found to be unreliable.

The insurer's medical assessments, which concluded the son's injuries fell within the Minor Injury Guideline, were accepted.