6 total
Application for accident benefits dismissed; applicant failed to prove injuries warranted removal from the Minor Injury Guideline.
The applicant sought statutory accident benefits following a motor vehicle accident, claiming her injuries warranted removal from the Minor Injury Guideline (MIG) due to chronic pain and a pre-existing psychological condition.
The Licence Appeal Tribunal found insufficient medical evidence to establish chronic pain with a functional limitation.
Furthermore, the Tribunal relied on a section 44 psychological assessment to conclude that the applicant's pre-existing psychological condition did not prevent her from achieving maximal recovery within the MIG limits.
The application was dismissed, and the applicant was held to the MIG.
Application for statutory accident benefits dismissed as proposed treatments were not reasonable and necessary.
The applicant sought statutory accident benefits following a motor vehicle accident, including chiropractic services, psychological services, and medication expenses.
The Licence Appeal Tribunal dismissed the application, finding that the proposed chiropractic and psychological treatments were not reasonable and necessary based on the respondent's expert medical assessments, which showed no objective physical impairments and a deterioration in mood despite prior psychological treatment.
The medication expense had already been reimbursed.
Claims for interest and a special award were also dismissed.
Application for non-earner benefits and treatment plans dismissed; functional limitations attributed to pre-existing conditions and weight gain.
The applicant, who was wheelchair-bound prior to the accident, was struck by a truck and sought statutory accident benefits, including non-earner benefits and various treatment plans.
The Licence Appeal Tribunal dismissed the application, finding that the applicant's injuries were soft tissue in nature and that she failed to demonstrate a complete inability to carry on a normal life.
The Tribunal preferred the evidence of the respondent's medical assessors, concluding that the applicant's ongoing functional limitations were largely attributable to a significant post-accident weight gain and pre-existing conditions rather than the accident.
Claims for physiotherapy, psychological services, occupational therapy, and an award for unreasonably withheld benefits were also dismissed.
Application for catastrophic impairment designation and functional abilities evaluation dismissed; impairment threshold not met.
The applicant sought statutory accident benefits following a motor vehicle accident, claiming she sustained a catastrophic impairment under Criterion 7 (55% whole person impairment).
The Licence Appeal Tribunal reviewed competing medical assessments and preferred the respondent's experts, finding the applicant's combined physical and psychological impairments resulted in a 26% whole person impairment, falling short of the 55% threshold.
The Tribunal also dismissed the applicant's claim for a functional abilities evaluation, finding it was not reasonable and necessary, and consequently denied claims for interest and a special award.
Applicant's injuries deemed minor; removal from Minor Injury Guideline denied due to insufficient medical evidence.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied certain treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant argued for removal from the MIG based on pre-existing conditions (Crohn's disease and knee pain), chronic pain, and psychological impairment.
The Tribunal found the applicant failed to provide compelling medical evidence that his pre-existing conditions prevented maximal recovery within the MIG.
The Tribunal also rejected the applicant's claims of chronic pain and psychological impairment, preferring the respondent's expert evidence.
The applicant was found to remain within the MIG and was entitled to the disputed treatment plans only up to the remaining $2,570.75 of the $3,500 MIG limit.
The respondent's request for costs was denied for failing to provide particulars.
Accident benefits claim dismissed; injuries found to be minor and non-earner benefit claim time-barred.
The insurer determined the applicant suffered predominantly minor injuries and denied treatment beyond the $3,500 limit, as well as income replacement and non-earner benefits.
The Tribunal found the applicant's claim for a non-earner benefit was barred because he qualified for an income replacement benefit and missed the two-year limitation period.
The Tribunal declined to extend the limitation period.
On the merits, the Tribunal concluded the applicant's injuries were predominantly minor and that he was not entitled to an income replacement benefit, as surveillance evidence and his failure to report income undermined his claims.
No linked lawyers found.
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