Louise Koepfler

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the insurer's denial of psychological services, chiropractic treatments, a chronic pain assessment, and a chronic pain program.

The Licence Appeal Tribunal found the psychological, chiropractic, and chronic pain program treatments to be reasonable and necessary, preferring the evidence of the applicant's treating practitioners over the insurer's assessors.

The claim for a chronic pain assessment was denied as redundant.

The applicant was awarded interest on overdue payments, but claims for a special award and costs were dismissed.

The applicant, a self-employed house painter, was injured in a motor vehicle accident and received statutory accident benefits until July 1993.

He sought ongoing weekly income benefits, claiming he was unable to work due to headaches, dizziness, and musculoskeletal pain.

The arbitrator reviewed extensive medical and functional capacity evidence, concluding that the applicant suffered from soft tissue injuries and physical deconditioning, but was not substantially unable to perform the essential tasks of his employment.

The arbitrator rejected the applicant's claim of chronic pain syndrome, finding it unsupported by the weight of the medical evidence.

Furthermore, the arbitrator held that the insurer was not obligated under section 281(3) of the Insurance Act to pay benefits during a work-hardening program, as the mediator's report did not record a final offer to that effect.

The application for ongoing benefits was dismissed, and the applicant was ordered to repay interim benefits, though he was awarded his reasonable arbitration expenses.