Ms. Westbrook

The applicant was injured in a motor vehicle accident and received income replacement benefits (IRBs) for approximately 13 years before the respondent insurer terminated them.

The applicant sought post-104 week IRBs, arguing that his chronic pain, reliance on opioids, and resulting cognitive issues prevented him from working.

The respondent relied on independent medical examinations and video surveillance to argue the applicant could perform light duties.

The Tribunal found that the applicant's pain and medication use severely limited his functionality, rendering him unable to sustain competitive employment.

The Tribunal held that the applicant met the test for post-104 week IRBs and awarded the benefits with interest.

The respondent's request for costs was denied.

The applicant sought payment for an income replacement benefit, chiropractic services, psychological services, and custom orthotics following a motor vehicle accident.

The Licence Appeal Tribunal dismissed all claims.

The applicant failed to prove a substantial inability to perform the essential tasks of his pre-accident employment after May 2017.

The chiropractic treatment plans were not shown to be reasonable and necessary, the psychological services were duplicative, and the custom orthotics expense was incurred before submitting a treatment plan, contrary to section 38(2) of the Schedule.

The applicant sought income replacement benefits (IRBs) and various medical benefits following a motor vehicle accident.

The insurer terminated IRBs and denied further medical benefits on the basis that the applicant's injuries were predominantly minor and the $3,500 Minor Injury Guideline (MIG) limit had been exhausted.

The Tribunal found that the applicant did not suffer a substantial inability to perform the essential tasks of her pre-accident employment, relying on insurer examinations that showed her impairment was temporary and self-limited.

The Tribunal also held that the applicant failed to provide compelling medical evidence that her pre-existing conditions prevented her from achieving maximal recovery under the MIG.

The application was dismissed.

The applicant was injured in a motor vehicle accident and sought income replacement benefits after the respondent terminated them.

The applicant, a personal support worker, returned to work on modified duties and reduced hours.

The Tribunal found that the applicant suffered soft tissue injuries to her cervical and lumbar spine, rendering her substantially unable to perform the physically demanding essential tasks of her pre-accident employment.

The Tribunal ordered the respondent to pay the income replacement benefits with interest, but declined to award costs as the applicant failed to provide evidence of unreasonable conduct by the respondent.