Dr. Mor

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

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

The Tribunal found the applicant was removed from the MIG due to accident-related chronic pain that impaired her function, relying on treating practitioner records and the insurer's own physiatry assessments.

The Tribunal awarded partial entitlement to attendant care benefits, but found them not payable as they had not been incurred.

Various treatment plans for occupational therapy, assistive devices, a psychological assessment, and physiotherapy were partially or fully approved as reasonable and necessary.

The applicant's claim for a special award was dismissed due to procedural non-compliance in her submissions.

The applicant sought ongoing Income Replacement Benefits (IRBs) and a psychological assessment following a motor vehicle accident.

The insurer terminated IRBs after 104 weeks, arguing the applicant no longer met the test for entitlement.

The Tribunal found that while the applicant suffered from accident-related physical and psychological impairments, he failed to prove a substantial or complete inability to work as a real estate agent.

The applicant's credibility was significantly undermined by a forensic accounting report revealing he misrepresented his pre- and post-accident income to all assessors, and that he actually earned more in the year following the accident.

Consequently, the claim for ongoing IRBs was dismissed.

However, the Tribunal granted the $2,000 psychological assessment, finding it reasonable and necessary to address the applicant's ongoing psychological impairment.

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 applicant argued for removal from the MIG based on pre-existing jaw pain, psychological issues, and chronic pain.

The Tribunal found insufficient medical evidence to support removal from the MIG, noting a lack of chronic pain diagnosis and preferring the respondent's psychological assessment which found symptom magnification.

As the MIG limits were exhausted, the claims for treatment plans and interest were dismissed.

The applicant sought reconsideration of a LAT decision that denied her claims for psychological, chiropractic, and massage therapy benefits.

She argued the adjudicator erred in fact and law, violated procedural fairness, and sought to introduce a new letter from her supervising psychologist to validate her psychological assessment report.

The adjudicator waived the late filing of the reconsideration request but dismissed it on the merits.

The adjudicator found the new letter did not meet the test for new evidence and would not have changed the outcome, as the original decision reasonably relied on the applicant's own statements to the insurer's assessor that she did not want or need the claimed treatments.

The applicant sought income replacement benefits (IRBs) following a motor vehicle accident, claiming physical and psychological injuries prevented him from working.

The Licence Appeal Tribunal found that the applicant's physical complaints, including chronic back pain and suspected radiculopathy, were long-standing pre-existing conditions that were not exacerbated by the minor accident.

While the Tribunal accepted that the applicant sustained psychological injuries, it rejected the applicant's psychiatric expert evidence because it relied on inaccurate self-reporting.

The Tribunal concluded the applicant failed to prove a substantial inability to perform the essential tasks of his employment or any employment, and dismissed the application for IRBs, interest, and an award.

The applicant sought reconsideration of a decision denying income replacement benefits and various treatment plans on the basis that his injuries fell within the Minor Injury Guideline (MIG).

The applicant argued the adjudicator made significant errors of law and fact in weighing the medical evidence regarding his physical limitations, psychological impairment, and chronic pain.

The adjudicator dismissed the reconsideration request, finding no errors of law or fact in the original decision.

The adjudicator reaffirmed that the applicant failed to meet the burden of proving his injuries fell outside the MIG or that he suffered a substantial inability to perform the essential tasks of his employment.

The applicant sought statutory accident benefits following a motor vehicle accident, including medical benefits and an income replacement benefit.

The insurer denied the claims on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and that he did not meet the test for an income replacement benefit.

The Licence Appeal Tribunal found that the applicant's physical and psychological injuries were predominantly minor and subject to the MIG limit, which had been exhausted.

The Tribunal also found that the applicant did not suffer a substantial inability to perform the essential tasks of his employment and was therefore not entitled to an income replacement benefit.

The application was dismissed.

The 79-year-old applicant sought non-earner benefits following a motor vehicle accident.

The insurer paid benefits until January 28, 2017, but terminated them based on multidisciplinary assessments indicating the applicant no longer suffered a complete inability to carry on a normal life.

The Tribunal applied the Heath framework and found that, due to successful physiotherapy and psychotherapy, the applicant had recovered sufficiently to engage in substantially all of his pre-accident activities.

The Tribunal also found the applicant non-compliant for failing to attend a scheduled insurer examination in September 2018, providing an independent basis for termination.

The application was dismissed.

The applicant sought medical benefits for chronic pain treatment following a motor vehicle accident, which the respondent insurer denied based on its own medical examinations.

The Tribunal preferred the evidence of the applicant's chronic pain specialist over the insurer's examiners, finding that the applicant suffered from ongoing physical and psychological pain.

The Tribunal ordered the respondent to pay the disputed medical benefit and interest, but declined to order a special award, finding the insurer's denial was not unreasonable.