4 total
Application for accident benefits dismissed; injuries fell within the Minor Injury Guideline.
The applicant sought statutory accident benefits following a motor vehicle accident.
The insurer denied funding for several treatment and assessment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant argued that pre-existing conditions and chronic pain precluded his recovery within the MIG.
The Tribunal found no evidence that the applicant's advanced age, prior knee surgery, or lingering shoulder pain impaired his recovery.
Furthermore, the applicant failed to meet the criteria for a chronic pain condition under the AMA Guides.
The Tribunal concluded the applicant sustained minor injuries subject to the $3,500 MIG limit and dismissed the application for the disputed medical benefits and interest.
Insurer's procedural non-compliance results in partial award of non-earner and medical benefits despite minor injuries.
The applicant sought non-earner benefits and medical benefits following a motor vehicle accident.
The insurer denied the claims, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant sustained a minor injury and did not suffer a complete inability to carry on a normal life.
However, because the insurer failed to comply with the notice provisions under sections 36 and 38 of the Schedule, the applicant was awarded non-earner benefits for the period of non-compliance (January 18 to April 30, 2019) and an attendant care assessment plan incurred during the period of non-compliance.
The remaining assessment plans were denied as not reasonable and necessary, and the claim for an award was dismissed.
Application for accident benefits dismissed as injuries were minor and applicant missed no work.
The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to an income replacement benefit (IRB) and medical benefits for psychological and chiropractic treatment.
The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and were subject to the $3,500 limit.
The Tribunal found that the applicant failed to prove he suffered from chronic pain syndrome or chronic pain causing functional impairment, thus his injuries were predominantly minor.
The Tribunal also dismissed the claim for an IRB because the applicant did not miss any work due to the accident and failed to submit a required disability certificate.
As the minor injury limit was exhausted, the claims for medical benefits, interest, and an award for unreasonable delay were dismissed.
Applicant's injuries fall within the Minor Injury Guideline; claim for physiotherapy benefits dismissed.
The applicant was injured in a motor vehicle accident and sought medical benefits for physiotherapy.
The respondent denied the claim, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) limit of $3,500.
The applicant argued for removal from the MIG due to pre-existing cervical disc disease, chronic pain, and psychological impairment.
The Tribunal found that the applicant's injuries were predominantly minor, noting that his post-accident shoulder and neck issues were likely related to his pre-existing degenerative disc disease and bodybuilding routine rather than the accident.
The Tribunal afforded little weight to the applicant's chronic pain assessment as it failed to address his workout routine.
Consequently, the applicant was not removed from the MIG, and the claim for $3,030.78 in physiotherapy services was dismissed.
No linked lawyers found.
No linked judges found.