7 total
Application for physiotherapy benefits dismissed as applicant failed to prove treatment was reasonable and necessary.
The applicant, a pedestrian struck by a vehicle, sought payment for three physiotherapy treatment plans under the Statutory Accident Benefits Schedule.
The respondent denied the benefits, relying on section 44 assessments indicating no further physical rehabilitation was necessary.
The Tribunal found the applicant's medical evidence unpersuasive, as the reports were either based on phone consultations, lacked physical examinations, or contradicted hospital records.
The Tribunal preferred the respondent's assessments and dismissed the application, finding the treatment plans were not reasonable or necessary.
Applicant removed from Minor Injury Guideline; physical treatment plans approved but attendant care benefits denied.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including attendant care benefits and various treatment plans.
The respondent denied the benefits, arguing the applicant was bound by the Minor Injury Guideline (MIG).
The Tribunal found the applicant was not bound by the MIG due to psychological injuries, relying on an insurer's examination report.
The Tribunal granted entitlement to the physical treatment plans (physiotherapy and chiropractic) as reasonable and necessary, but denied the attendant care benefits and the unapproved balances of the psychological treatment plans for lack of evidence.
Application for accident benefits dismissed; injuries fell within the Minor Injury Guideline and IRB test unmet.
The applicant sought accident benefits following a motor vehicle accident, disputing the insurer's determination that her injuries fell within the Minor Injury Guideline (MIG).
The applicant argued she should be removed from the MIG due to pre-existing back issues and chronic pain.
The Tribunal found the applicant failed to provide compelling medical evidence that a pre-existing condition prevented her maximal recovery within the MIG, nor did she establish a diagnosis of chronic pain with functional impairment.
The Tribunal also dismissed the claim for income replacement benefits, finding the applicant did not prove a substantial inability to perform the essential tasks of her employment as a production packer.
As the applicant's injuries were deemed minor, the disputed treatment plans were denied for exceeding the $3,500 MIG limit.
The application was dismissed.
Application for accident benefits dismissed as injuries fell within the Minor Injury Guideline limits.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied various treatment and assessment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The adjudicator found that the applicant's physical and psychological injuries were predominantly minor and that she failed to establish that pre-existing conditions or chronic pain warranted removal from the MIG.
As the $3,500 MIG limit had been exhausted, the disputed treatment plans were deemed not reasonable and necessary, and the application was dismissed.
Applicant removed from Minor Injury Guideline due to psychological impairment; partial treatment benefits awarded.
The respondent denied certain treatment plans and assessments, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant sustained a psychological impairment, removing him from the MIG.
The Tribunal ordered the respondent to pay for a psychological assessment, a chronic pain assessment, and portions of the proposed psychological treatment and chronic pain program, along with interest.
The applicant's claim for a special award under s. 10 of Regulation 664 was dismissed.
Applicant's injuries deemed minor under the MIG; claims for chronic pain and psychological impairment dismissed.
The respondent determined the applicant's injuries were minor and subject to the $3,500 funding limit under the Minor Injury Guideline (MIG), denying several treatment and assessment plans.
The applicant argued she suffered from psychological impairments and chronic pain.
The Tribunal found the applicant did not sustain a psychological impairment, preferring the respondent's psychological assessment over the applicant's evidence.
The Tribunal also found the applicant did not meet the criteria for chronic pain syndrome, preferring the respondent's musculoskeletal assessments over the family doctor's diagnosis.
As the injuries were minor and the funding limit was exhausted, the disputed treatment plans were not payable.
Claims for interest and costs were dismissed.
Accident benefits denied as injuries fell within the Minor Injury Guideline and treatment plans lacked evidentiary support.
The applicant sought statutory accident benefits following a rear-end motor vehicle collision.
The respondent denied certain treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant's injuries were minor and subject to the MIG funding limit, preferring the evidence of the respondent's assessors over the applicant's assessor, whose opinion relied heavily on self-reporting without objective validation.
The disputed treatment plans, special award, and costs were denied due to a lack of supporting evidence.
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