Ms. Kozina

The applicant was involved in a motor vehicle accident and sought statutory accident benefits.

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

The applicant applied to the Licence Appeal Tribunal, arguing for removal from the MIG due to chronic pain and psychological impairments.

The Tribunal found that the applicant failed to meet the burden of proving chronic pain with a functional impairment under the AMA Guidelines, noting normal physical exams and lack of compelling evidence of functional decline.

The Tribunal also found insufficient evidence of a psychological condition, citing multiple assessments indicating symptom exaggeration and malingering.

The application was dismissed, and the applicant remained subject to the $3,500 MIG limit.

The applicant was injured in a motor vehicle accident and sought income replacement benefits, medical and rehabilitation benefits (including a Tempur mattress and a lightweight laptop), and a neuropsychological re-assessment.

The arbitrator found that the applicant did not suffer a substantial inability to perform the essential tasks of her pre-accident employment, as she continued to work and earn similar income post-accident.

The claims for the mattress, laptop, and re-assessment were dismissed as they were not proven to be reasonable and necessary.

The insurer's claim for repayment of advances was also dismissed due to lack of proper notice within the 12-month limitation period.