27 total
Applicant awarded partial attendant care benefits after Tribunal finds accident materially contributed to her impairments.
The applicant sought statutory accident benefits following a motor vehicle accident, including attendant care, medical and rehabilitation benefits, and a functional abilities evaluation.
The respondent insurer denied the benefits, arguing the applicant's impairments were not caused by the accident and that she was independent in her activities of daily living.
The Tribunal found that the accident was a necessary cause of the applicant's impairments, satisfying the 'but for' test, and that her injuries were not minor.
Relying on the in-person observations of the respondent's occupational therapist over the virtual assessment of the applicant's expert, the Tribunal concluded that some attendant care was reasonable and necessary.
The applicant was awarded partial attendant care benefits of $2,820.16 with interest, but her claims for medical and rehabilitation benefits and the functional abilities evaluation were dismissed for lack of evidence.
Application for statutory accident benefits dismissed as proposed treatment plans were not reasonable and necessary.
The applicant sought statutory accident benefits following a 2017 motor vehicle accident, claiming entitlement to a chronic pain treatment program, a neurological examination, and a psychological examination.
The respondent denied the treatment plans, arguing the applicant had reached maximum medical recovery and had no ongoing impairments.
The Tribunal found that the applicant's functional abilities, normal gait, and lack of reliance on pain medication undermined the need for the chronic pain program.
Furthermore, previous assessments had already concluded the applicant suffered no neurological or psychological impairments.
The application was dismissed in its entirety.
The applicant was injured in a motor vehicle accident and sought payment for various medical and rehabilitation benefits, including chiropractic, physiotherapy, occupational therapy, a brain SPECT scan, an EMG assessment, and cognitive devices.
The respondent insurer denied the treatment plans on the basis that they were not reasonable and necessary.
The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to meet his burden of proof.
The Tribunal afforded little weight to the applicant's medical experts due to factual inaccuracies in their reports and relied on the respondent's assessors, who concluded the applicant had reached maximum medical improvement and that the proposed treatments were not medically justified.
Application for catastrophic impairment designation dismissed; applicant failed to meet the 55% WPI or marked impairment thresholds.
The applicant sought a determination that she sustained a catastrophic impairment following a motor vehicle accident, claiming entitlement to attendant care, medical, and rehabilitation benefits beyond the $65,000 non-catastrophic limit.
The Tribunal assessed her impairments under criteria 7 (whole person impairment) and 8 (mental or behavioural impairment) of the Statutory Accident Benefits Schedule.
The adjudicator found the applicant's combined whole person impairment was 42%, falling short of the 55% threshold, and that she did not suffer a marked impairment in three or more areas of function.
Consequently, the application for benefits and a section 10 award was dismissed.
The Tribunal also dismissed the applicant's motion for punitive damages for lack of jurisdiction and awarded $2,000 in costs to the respondent due to the applicant bringing frivolous and vexatious motions alleging criminal conduct and contempt.
Applicant awarded post-104-week IRBs due to complete inability to work from post-concussion syndrome.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including post-104-week income replacement benefits (IRBs), attendant care benefits, and funding for medical assessments.
The Tribunal found the applicant was entitled to ongoing IRBs, as her post-concussion syndrome and chronic pain resulted in a complete inability to engage in any employment for which she was reasonably suited.
The Tribunal also approved a neuropsychological assessment but denied a speech language pathology assessment, noting the applicant's post-accident public speaking engagements.
Claims for attendant care benefits, a special award, and costs were dismissed.
Tribunal awards chiropractic benefits for accident-exacerbated fibromyalgia but denies neurological assessment lacking structural evidence.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits for chiropractic services and a neurological assessment, which the insurer denied.
The Licence Appeal Tribunal found that the applicant's pre-existing fibromyalgia was exacerbated by the accident, making the chiropractic treatment plan reasonable and necessary for pain management.
However, the Tribunal denied the neurological assessment, relying on an insurer's examination and the applicant's own treating neurologists who found no neurological structural disease.
The applicant was awarded the cost of the chiropractic services and interest.
Application for costs of neurological examinations dismissed as applicant failed to prove a traumatic brain injury.
The applicant sought entitlement to the costs of three examinations (a Neurology Assessment, an E.E.G., and an MRI) following a motor vehicle accident, claiming he suffered a head injury causing headaches and pain.
The respondent denied the benefits, arguing the applicant's headaches were cervicogenic and related to a soft-tissue injury.
The Tribunal found no objective medical evidence of a neurological disability or impairment resulting from the accident.
Relying on the reports of the insurer's examiner and other specialists, which aligned with the family doctor's findings, the Tribunal concluded the examinations were not reasonable and necessary.
The application was dismissed.
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