Dr. Marchie

The applicant was injured in a rear-end motor vehicle accident and sought statutory accident benefits, including a determination of catastrophic impairment.

The Licence Appeal Tribunal found that the applicant sustained a catastrophic impairment under Criterion 8, concluding she suffered a class 5 extreme impairment in social function and class 4 marked impairments in concentration, persistence, pace, and adaptation due to mental and behavioural disorders.

The Tribunal awarded attendant care benefits at a reduced rate of $785.25 per month and approved several medical and rehabilitation treatment plans, including occupational therapy, physiotherapy, aquatherapy, and pet therapy.

The Tribunal also ordered the respondent to pay a 50% special award under s. 10 of Reg. 664, totaling $7,336.27, finding that the insurer unreasonably denied critical treatment plans early in the applicant's recovery.

The applicant sought a determination that she sustained a catastrophic impairment (CAT) and was entitled to post-104-week income replacement benefits (IRBs) following a 2018 motor vehicle accident.

The Tribunal found that the applicant did not meet the CAT threshold under Criterion 7, as her evidence failed to transparently apply the AMA Guides' methodology and improperly double-counted impairments, whereas the respondent's assessments credibly established a 15% Whole Person Impairment.

The Tribunal also found the applicant did not meet Criterion 8, preferring the respondent's functional observations showing independence in daily activities over the applicant's self-reported limitations.

Finally, the Tribunal dismissed the claim for post-104-week IRBs, concluding the applicant failed to prove a complete inability to engage in reasonably suited employment, given evidence of ongoing functional capacity and post-accident earnings.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits, which were denied by the respondent insurer.

The applicant applied to the Licence Appeal Tribunal, arguing his injuries fell outside the Minor Injury Guideline (MIG) due to pre-existing conditions, chronic pain, and psychological impairments.

The Tribunal found the applicant failed to provide compelling medical evidence to support removal from the MIG, noting a lack of evidence linking his chronic pain or psychological complaints to the subject accident.

The Tribunal also dismissed the applicant's claim for a non-earner benefit, finding he failed to submit a disability certificate within the required 104-week period and did not meet the test for a complete inability to carry on a normal life.

Claims for medical benefits, examination expenses, and interest were similarly dismissed.

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

The respondent initially denied treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

Prior to the hearing, the respondent removed the applicant from the MIG and approved the disputed psychological treatment plans based on new medical evidence.

The Tribunal found the applicant was entitled to a physiatry/chronic pain assessment, as her ongoing pain complaints and the respondent's own assessments demonstrated a need for further investigation.

The Tribunal declined to order an award for unreasonable delay, finding the respondent appropriately adjusted the file as medical evidence evolved.

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

The insurer denied several treatment plans and an income replacement benefit, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that the applicant sustained a psychological impairment, removing her from the MIG.

The Tribunal approved treatment plans for psychological services, a psychological assessment, physiotherapy, and a chronic pain assessment, finding them reasonable and necessary.

However, claims for chiropractic services and an income replacement benefit were dismissed due to insufficient evidence.

The Tribunal awarded interest on the approved benefits but declined to order a special award, finding the insurer's conduct was not unreasonable.

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

The Tribunal found that the applicant failed to prove his injuries fell outside the Minor Injury Guideline (MIG) on the basis of psychological impairment or chronic pain, preferring the respondent's psychological evidence.

However, the Tribunal found the applicant was entitled to Income Replacement Benefits (IRBs) for a closed period, preferring the evidence of the applicant's chiropractor and clinical records over the respondent's physiatrist.

The claims for disputed treatment plans were dismissed as the MIG limits were exhausted, and the claim for a special award was dismissed.

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).

The applicant argued that a pre-existing condition and chronic pain warranted removal from the MIG.

The Tribunal found that the applicant failed to establish a nexus between his pre-existing conditions and the accident-related injuries, and failed to demonstrate functional impairment from chronic pain, noting he had returned to full-time work and reported no longer experiencing pain.

As the MIG limits were exhausted, the claims for attendant care and physiotherapy were dismissed, along with claims for interest and a section 10 award.

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

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

The Tribunal found the applicant was not subject to the MIG due to chronic pain and associated functional impairments.

The Tribunal granted the proposed chiropractic treatment plan, finding it reasonable and necessary to manage pain symptoms, and awarded interest on this plan.

However, the Tribunal denied the claim for a non-earner benefit, as the applicant failed to prove a complete inability to carry on a normal life, and denied the psychological assessment due to insufficient evidence linking the psychological impairments to the accident.

The applicant was injured in a motor vehicle accident and sought various medical and rehabilitation benefits from the respondent insurer.

The insurer denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit had been exhausted.

The applicant argued she should be removed from the MIG due to pre-existing injuries and psychological impairments.

The Tribunal found insufficient evidence of pre-existing conditions preventing recovery or clinically significant psychological impairments, preferring the respondent's psychological assessment over the applicant's.

The Tribunal concluded the applicant's injuries were predominantly minor, and since the MIG limits were exhausted, the claims for treatment plans and interest were dismissed.

The applicant sought statutory accident benefits, including an income replacement benefit (IRB) and medical benefits for physiotherapy and psychotherapy, after allegedly being struck by a reversing vehicle.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to prove she was employed at the time of the accident or that she suffered a substantial inability to perform the essential tasks of her employment.

The Tribunal also denied the treatment plans, preferring the respondent's section 44 assessments which found no objective musculoskeletal or psychological impairments, and noting a lack of contemporaneous complaints in the applicant's medical records.

The applicant sought medical benefits following a motor vehicle accident.

The respondent insurer denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit had been exhausted.

The Tribunal found that the medical evidence, including reports from physiatrists and a psychologist, confirmed the applicant sustained soft tissue injuries consistent with the MIG.

The applicant failed to provide sufficient evidence of chronic pain or psychological impairment to warrant removal from the MIG.

The application was dismissed.

The applicant sought non-earner benefits, medical and rehabilitation benefits, and a special award following a 2012 motor vehicle accident.

The arbitrator dismissed all claims, finding the applicant lacked credibility due to numerous inconsistencies, misrepresentations, and evidence of symptom exaggeration.

The arbitrator placed little weight on the applicant's treating practitioners, preferring the evidence of the insurer's assessors who conducted more thorough document reviews and found the applicant did not suffer a complete inability to carry on a normal life and that the proposed treatments were not reasonable and necessary.

The applicant sought accident benefits following a motor vehicle accident.

The insurer denied the claims on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued that her injuries, including drop attacks, a knee injury, chronic pain, and psychological issues, removed her from the MIG.

The Tribunal found that the applicant failed to establish on a balance of probabilities that her drop attacks and knee injury were caused by the accident, applying the 'but for' test.

Furthermore, the applicant did not provide compelling evidence of a pre-existing psychological condition that would prevent maximal recovery.

As the applicant's injuries were predominantly minor and she had exhausted the $3,500 MIG limit, her claims for further chiropractic services and interest were dismissed.

The applicant sought a non-earner benefit and payment for two physiotherapy treatment plans following a motor vehicle accident.

The Tribunal found that the claim for the non-earner benefit was statute-barred, as the application was filed more than two years after the clear and unequivocal denial by the respondent.

The Tribunal also dismissed the claims for the medical benefits, finding that the applicant failed to provide sufficient contemporaneous medical evidence to prove the treatment plans were reasonable and necessary.

The respondent's request for costs was denied.