3 total
Accident benefits denied as applicant's injuries fell within the Minor Injury Guideline's $3,500 limit.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent insurer denied the claims, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and were subject to the $3,500 limit.
The applicant argued for removal from the MIG based on a pre-existing knee condition, chronic pain, and psychological impairments.
The Tribunal found insufficient evidence that the pre-existing condition would prevent maximal recovery.
Relying on the respondent's independent medical examinations, the Tribunal concluded the applicant did not suffer from chronic pain or a psychological impairment caused by the accident.
The injuries were deemed predominantly minor, and the claims for chiropractic services were denied.
Application for accident benefits dismissed due to failure to prove complete inability and non-attendance at insurer examinations.
The applicant sought non-earner benefits, attendant care benefits, and the cost of a chronic pain assessment following a motor vehicle accident.
The adjudicator found the applicant was barred from pursuing the chronic pain assessment due to her failure to attend section 44 insurer examinations without a valid reason.
The claims for non-earner and attendant care benefits were dismissed because the applicant failed to establish a complete inability to carry on a normal life or that the attendant care expenses were incurred, with the adjudicator preferring the respondent's medical evidence and noting inconsistencies in the applicant's self-reporting and treating physician's records.
Applicant awarded ongoing income replacement and medical benefits due to chronic pain; special award denied.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits from the insurer, including income replacement benefits (IRBs) and medical benefits.
The insurer denied the benefits based on its assessors' reports, which concluded the applicant could return to his pre-accident employment as a heavy labourer.
The arbitrator found the applicant's evidence and his experts' reports more credible, noting the insurer's assessors lacked complete information and ignored the applicant's chronic pain.
The arbitrator held that the applicant met the test for IRBs both before and after the 104-week mark, as he suffered a complete inability to engage in suitable employment.
The requested medical benefits were also found to be reasonable and necessary.
However, the arbitrator dismissed the claim for a special award, finding the insurer did not act unreasonably in relying on its medical assessors, despite the flaws in their reports.
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