Dr. L. Majl

The applicant was a pedestrian struck by a vehicle and sought statutory accident benefits.

The respondent insurer limited the applicant's medical and rehabilitation benefits to the $3,500 cap under the Minor Injury Guideline (MIG).

The applicant applied to the Licence Appeal Tribunal, arguing that chronic pain and psychological impairment warranted removal from the MIG.

The adjudicator found that the applicant failed to prove on a balance of probabilities that he suffered from chronic pain or a psychological impairment, preferring the objective findings of the insurer's examination assessors over the subjective reports of the applicant's experts.

As the injuries fell within the MIG and the maximum benefits had already been approved, the disputed treatment plans were denied.

The claims for an award and costs were also dismissed, as the insurer did not act unreasonably.

The applicant sought income replacement benefits (IRBs) and the cost of examinations following a minor rear-end motor vehicle accident.

The respondent insurer terminated IRBs after the applicant returned to work, arguing that her subsequent periods off work were due to pre-existing conditions, a shortage of work, and a subsequent work-related injury.

The Tribunal applied the "but for" test for causation and found that the applicant's ongoing impairments were not caused by the accident.

The Tribunal noted significant credibility issues, as the applicant provided inaccurate histories to her medical assessors regarding her prior neck pain and subsequent workplace injury.

The Tribunal preferred the evidence of the respondent's experts and concluded the applicant did not meet the tests for substantial inability or complete inability to work.

The claims for IRBs, an accounting report, a special award, and costs were dismissed, though the applicant was awarded $200 for a disability certificate.