Dr. Marchuk

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 Tribunal found the applicant failed to prove his injuries warranted removal from the MIG, noting a lack of compelling medical evidence and a clinical note indicating the applicant denied significant physical injury.

The Tribunal also found the respondent's denial notices complied with the Schedule.

The application for chiropractic services, a doctor's visit, interest, and an award was dismissed.

The applicant sought non-earner benefits and interest following a motor vehicle accident.

The Licence Appeal Tribunal applied the Heath test to determine if the applicant suffered a complete inability to carry on a normal life.

While the Tribunal accepted that the applicant's injuries prevented him from continuing his pre-accident employment and impacted his housekeeping duties, it found that his personal care tasks were not sufficiently affected.

The Tribunal concluded the applicant failed to meet the high threshold for non-earner benefits.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, arguing that psychological impairments and chronic pain warranted removal from the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that the applicant's injuries were predominantly soft tissue in nature and that there was insufficient objective medical evidence to substantiate the claims of psychological impairment or chronic pain.

Consequently, the applicant remained subject to the $3,500 MIG limit, and the disputed treatment plans, special award, and interest were denied.

The applicant sought statutory accident benefits following a motor vehicle accident, including treatment plans for physiotherapy, driving counselling, chronic pain, and a chronic pain assessment.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to prove the treatments and assessment were reasonable and necessary.

The Tribunal preferred the respondent's independent medical examination over the applicant's physiatrist, noting the applicant's self-reported full-time work and independence did not support a chronic pain diagnosis with functional impairment.

Claims for a special award and interest were also dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to income replacement benefits (IRBs) and a neurological assessment.

The Tribunal found that the applicant failed to prove she met the disability test for IRBs, as the medical evidence did not establish a substantial inability to perform the essential tasks of her self-employment.

However, because the respondent insurer issued deficient notices suspending and terminating the IRBs, the Tribunal ordered the respondent to pay IRBs totaling $9,783.83 for the period before a compliant notice was issued.

The claim for a neurological assessment was dismissed as not reasonable and necessary.

The Tribunal denied a special award but granted $500 in costs to the applicant due to the respondent's late service of an accounting report.

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

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

The Tribunal found that the applicant failed to prove on a balance of probabilities that his physical or psychological injuries warranted removal from the MIG.

The Tribunal preferred the respondent's s. 44 assessors over the applicant's experts, noting contradictions in the applicant's psychological evidence and a lack of objective medical documentation supporting significant impairment.

The application was dismissed.

The applicant sought statutory accident benefits following a 2017 motor vehicle accident, claiming catastrophic impairment, income replacement benefits (IRB), and various medical and rehabilitation benefits.

The Licence Appeal Tribunal found the applicant was not catastrophically impaired, as she did not demonstrate Marked or Class 4 impairments in three of four functional domains, relying partly on surveillance evidence showing her ability to socialize and complete tasks.

Consequently, her claim for attendant care benefits was dismissed.

However, the Tribunal granted her claim for a post-104-week IRB, finding her severe chronic pain and heavy medication use rendered her completely unable to engage in suitable employment.

Several treatment plans, including for medical marijuana and lidocaine injections, were approved as reasonable and necessary for pain relief, while others were denied.

The claim for an award for unreasonably withheld benefits was dismissed.

The applicant was injured in a motor vehicle accident and deemed catastrophically impaired.

They sought various statutory accident benefits, including attendant care benefits, medical and rehabilitation expenses, and an award for unreasonable delay.

The Licence Appeal Tribunal found the applicant entitled to a reduced amount of attendant care benefits, case management services, and chiropractic treatment, as the insurer had previously approved or partially approved these amounts.

The remaining claims for assessments, assistive devices, and other treatments were dismissed for lack of medical evidence proving they were reasonable and necessary.

The Tribunal declined to make an award under section 10 of Regulation 664, finding the insurer did not unreasonably withhold or delay payments.

The applicant sought statutory accident benefits for two physiotherapy treatment plans following a motor vehicle accident.

The respondent insurer denied the plans on the basis that they were not reasonable and necessary.

The Licence Application Tribunal dismissed the application, finding that the applicant failed to meet the burden of proof.

The Tribunal preferred the evidence of the respondent's physiatrist, who opined that the applicant's condition had plateaued and further facility-based treatment would not aid recovery, over the clinical notes of the applicant's family doctor and physiotherapist which showed only modest improvement.

The applicant was injured in a motor vehicle accident and sought medical and rehabilitation benefits, as well as the cost of assessments, from the respondent insurer.

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

The applicant argued that his chronic pain and psychological impairments warranted removal from the MIG.

The Tribunal found that the applicant failed to provide sufficient medical evidence demonstrating functional impairment or debilitating pain that would prevent his maximal medical recovery within the MIG.

The Tribunal preferred the insurer's medical assessments over the applicant's, noting inconsistencies between the applicant's self-reporting and objective testing.

The application was dismissed, and no benefits were awarded.

The applicant was injured in a motor vehicle accident and sought various medical and rehabilitation benefits under the Statutory Accident Benefits Schedule after being removed from the Minor Injury Guideline.

The insurer denied treatment plans for a cognitive assessment, chiropractic and massage treatments, and the remaining cost of a partially approved psychological assessment.

The Tribunal found the cognitive assessment and physical treatments were reasonable and necessary given the applicant's reported concussion symptoms and ongoing chronic pain.

However, the Tribunal dismissed the claim for the remaining cost of the psychological assessment, finding the applicant failed to prove why the additional time and cost were necessary beyond the insurer's partial approval.

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

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

The applicant argued that her chronic back pain and psychological impairments warranted removal from the MIG.

The Tribunal found that the applicant's physical injuries were soft-tissue in nature and fell squarely within the MIG, and that she failed to provide compelling evidence of a pre-existing condition, a formal diagnosis of chronic pain, or a psychological impairment that would prevent maximal medical recovery within the MIG limits.

As the MIG funding was exhausted, the disputed treatment plans were denied.

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

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

The applicant contended he suffered psychological injuries, relying on a psychological assessment diagnosing him with PTSD and depression.

The Tribunal found the applicant's self-reported normal daily routine and lack of psychological complaints to his family doctor contradicted the psychological diagnosis.

The Tribunal concluded the applicant's injuries fell within the MIG and dismissed the application for the cost of a psychological assessment.

The applicant sought approval for three treatment plans for chiropractic and massage therapy, and payment of the balance of a partially paid treatment plan, following a motor vehicle accident.

The insurer denied the plans on the basis that the applicant had reached maximum medical recovery.

The Licence Appeal Tribunal ordered the insurer to pay the outstanding balance on the partially paid invoices, finding that the clinical notes and records provided sufficient evidence that the services were rendered.

The Tribunal also approved the massage therapy portions of the denied plans for pain control, but denied the multiple body site therapy portions, accepting the insurer's medical examination evidence that the appellant had plateaued and the proposed therapy was not reasonable and necessary.

The applicant sought statutory accident benefits for physiotherapy and chiropractic treatment following a motor vehicle accident.

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

The Tribunal found that the applicant's physical and psychological injuries were minor and fell within the MIG, relying on the uncontradicted reports of the respondent's insurer examination assessors.

As the applicant had exhausted the $3,500 MIG limit, the claims for medical benefits were dismissed.

Claims for interest and costs were also dismissed.

The applicant sought statutory accident benefits for occupational therapy services and devices following a motor vehicle accident.

The respondent denied the benefits on the basis that the treatment plans were not reasonable and necessary.

The Tribunal found that the applicant failed to prove the treatment plans were reasonable and necessary, preferring the evidence of the respondent's occupational therapist whose findings were consistent with other assessors.

The Tribunal also found the respondent's denials were valid and dismissed the claims for interest and an award for unreasonable delay.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for various treatment plans and assessments.

The insurer denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline.

The Tribunal found that the applicant's chronic pain and the medical evidence supported that his injuries were not minor.

The Tribunal ordered the insurer to pay for four treatment plans for physical therapy and an orthopaedic assessment, finding them reasonable and necessary.

An in-home assessment was deemed incurred because the insurer unreasonably denied it without adequate medical reasons.

However, a cognitive assessment recommended by a chiropractor was denied as it was beyond the chiropractor's scope of practice and unsupported by psychological evidence.