3 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.
The respondent denied various treatment plans, arguing the applicant's injuries fell within the $3,500 Minor Injury Guideline (MIG) limit.
The applicant argued for removal from the MIG based on pre-existing physical and psychological impairments, accident-related psychological impairment, and chronic pain.
The Tribunal found the applicant failed to provide compelling medical evidence that his pre-existing conditions would prevent maximal medical recovery within the MIG.
The Tribunal also found insufficient evidence that the applicant suffered from accident-related psychological impairment or chronic pain with functional impairment.
The application was dismissed, and the applicant was found not entitled to the disputed treatment plans, interest, or an award.
Application for income replacement and medical benefits dismissed due to insufficient evidence of impairment.
The applicant sought income replacement benefits and approval for various treatment plans following a motor vehicle accident.
The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove on a balance of probabilities that he suffered a substantial inability to perform the essential tasks of his employment or a complete inability to engage in any employment.
The Tribunal preferred the respondent's medical evidence, noting inconsistencies in the applicant's expert reports and relying on the applicant's successful completion of a three-month accounting work placement.
The claims for treatment plans, an award, and interest were also dismissed.
Application for statutory accident benefits dismissed as proposed treatment and assessment plans were not reasonable and necessary.
The applicant was injured in a motor vehicle accident and sought various statutory accident benefits, including treatment plans for occupational therapy, a chronic pain program, and assessments for neuropsychological, chronic pain, functional cognitive, and catastrophic impairment, as well as a SPECT scan.
The insurer denied the claims.
The Licence Appeal Tribunal dismissed the application in its entirety, finding that the applicant failed to demonstrate on a balance of probabilities that the proposed plans were reasonable and necessary.
The Tribunal relied on insurer examination reports and surveillance evidence showing the applicant engaging in normal activities, which contradicted the applicant's self-reported functional limitations and the opinions of his assessors.
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