Leanne Wagner

The applicant sought statutory accident benefits following a motor vehicle accident, claiming catastrophic impairment due to a subdural hematoma, as well as entitlement to attendant care benefits, non-earner benefits, and various treatment plans outside the Minor Injury Guideline (MIG).

The Tribunal found that the subdural hematoma was a spontaneous occurrence unrelated to the accident.

The Tribunal further held that the applicant's injuries were predominantly minor, keeping her subject to the MIG limits.

Consequently, the claims for attendant care benefits, non-earner benefits, and treatment plans exceeding the MIG were dismissed.

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

The respondent insurer denied benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and later moved to bar the application under s. 55(1)2 of the Schedule for failure to attend insurer's examinations.

The Tribunal found the application was not barred because the insurer's notice lacked adequate reasons.

On the merits, the Tribunal concluded the applicant's psychological issues, including severe depression, pre-dated the accident and that the accident itself was a suicide attempt.

Consequently, the applicant failed to prove he sustained a psychological impairment caused by the accident or that a pre-existing condition prevented his recovery under the MIG.

The application for psychological benefits, an award, and interest was dismissed.

The applicant sought payment for a psychological treatment plan following a motor vehicle accident.

The insurer partially approved the plan, reducing the hourly rate to that of a social worker, reducing session lengths to one hour, and denying travel time and extra documentation fees.

The Tribunal found the appropriate hourly rate was $100 for a social worker in private practice, but restored the session length to 1.5 hours as the insurer provided no medical basis for the reduction.

The Tribunal denied travel time and extra documentation fees due to insufficient evidence.

The applicant was awarded the $600 balance with interest, but a claim for a special award was dismissed as the insurer's reliance on the Professional Fees Guideline was not unreasonable.

The applicant, who was involved in a motor vehicle accident, sought payment for various treatment plans including a neurological assessment, physiotherapy, chiropractic treatment, and psychological services under the Statutory Accident Benefits Schedule.

The respondent insurer denied the benefits.

The Licence Appeal Tribunal found that the applicant failed to prove on a balance of probabilities that the disputed treatment plans were reasonable and necessary.

The adjudicator noted inconsistencies in the applicant's self-reporting to assessors compared to her family doctor's records, and found the expert reports provided by both parties to be problematic or unpersuasive.

The application was dismissed in its entirety.

The applicant sought income replacement benefits (IRBs) following a motor vehicle accident.

The insurer terminated IRBs after 104 weeks, arguing the applicant did not meet the test for complete inability to work.

The Tribunal found that while the applicant failed to prove physical impairment, he successfully established that his psychological impairments, caused by the accident, rendered him completely unable to engage in any employment for which he was reasonably suited.

The Tribunal awarded IRBs from November 15, 2015, ongoing, with interest.

The respondent's request for costs was denied.