12 total
Application for accident benefits dismissed; applicant failed to prove injuries warranted removal from the MIG.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant failed to establish chronic pain with functional impairment or a psychological condition warranting removal from the MIG, noting inconsistencies in his self-reporting and preferring the insurer's psychological assessment.
The Tribunal also dismissed the claim for an income replacement benefit due to a lack of evidence regarding the applicant's employment and functional limitations.
The application was dismissed in its entirety.
Application for accident benefits dismissed as applicant failed to prove treatment plans were reasonable and necessary.
The applicant sought statutory accident benefits for various treatment plans, including assistive devices, psychological services, a chronic pain assessment, and a neurology assessment, following a 2018 motor vehicle accident.
The respondent denied the plans.
The Tribunal found that the applicant failed to prove on a balance of probabilities that the proposed treatment plans were reasonable and necessary.
The Tribunal also found that the respondent complied with the notice requirements under section 38 of the Schedule.
The application was dismissed in its entirety, and claims for interest and a section 10 award were denied.
Applicant's injuries found to be predominantly minor; claims for treatment plans beyond MIG limit dismissed.
The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) limit of $3,500.
The applicant argued his injuries fell outside the MIG due to psychological impairments, chronic pain, and pre-existing conditions.
The Tribunal found that the applicant sustained predominantly minor injuries (back and shoulder sprains) and failed to prove on a balance of probabilities that he suffered from an accident-related psychological impairment or chronic pain syndrome that would warrant removal from the MIG.
The Tribunal also found no compelling evidence of a pre-existing condition that would prevent maximal recovery within the MIG limit.
As the MIG limits were exhausted, the disputed treatment plans were denied, and no award for unreasonable delay was granted.
Applicant's chronic pain and psychological impairments warranted removal from the Minor Injury Guideline; benefits awarded.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits.
The respondent insurer denied several treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant sustained chronic pain and psychological impairments (including PTSD and driving phobia) that removed her from the MIG.
The Tribunal preferred the evidence of the applicant's treating practitioners and in-person assessors over the insurer's paper reviews and examinations.
The applicant was awarded all disputed medical and rehabilitation benefits, totaling over $10,000, plus interest on overdue payments.
Application for accident benefits dismissed; applicant failed to prove injuries warranted removal from Minor Injury Guideline.
The respondent denied various treatment plans and assessments on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant argued for removal from the MIG due to psychological impairments, chronic pain, and pre-existing conditions.
The Tribunal found insufficient evidence of a psychological impairment, noting the respondent's expert assessments were more persuasive.
The Tribunal also found no evidence of chronic pain syndrome with functional impairment, and no compelling evidence that pre-existing conditions precluded maximal recovery within the MIG.
The application was dismissed, and the applicant remained subject to the MIG limits.
Application for accident benefits dismissed as injuries fell within the Minor Injury Guideline limit.
The respondent denied several treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant failed to prove on a balance of probabilities that his physical injuries, pre-existing conditions, alleged psychological impairments, or chronic pain warranted removal from the MIG.
Relying on the respondent's section 44 medical assessments, the Tribunal concluded the injuries were predominantly minor.
As the $3,500 MIG limit had been exhausted, the disputed treatment plans were not payable, and claims for interest and an award were dismissed.
Claim for chiropractic services denied as applicant had reached maximum medical recovery for pre-existing back condition.
The applicant sought $1,733.72 for chiropractic services following a motor vehicle accident.
The respondent denied the benefit, arguing the applicant had reached maximum medical recovery.
The Tribunal found that the applicant had a pre-existing back condition with similar physical limitations prior to the accident.
Relying on the insurer's examination, the Tribunal concluded the proposed treatment was not reasonable and necessary, as it would only provide temporary relief without substantial functional restoration.
The application was dismissed.
Applicant failed to prove injuries fell outside the Minor Injury Guideline; treatment plans largely denied.
The applicant sought medical and rehabilitation benefits following a rear-end motor vehicle accident.
The respondent insurer denied the treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant claimed she suffered a mild traumatic brain injury, post-concussion syndrome, and chronic pain, warranting removal from the MIG.
The Tribunal found the applicant's medical evidence, including a neurologist's report, unconvincing and unsupported by objective testing.
Preferring the respondent's multidisciplinary assessments, the Tribunal concluded the applicant's injuries were predominantly minor.
The applicant was awarded the remaining $1,278.19 of her MIG limit towards one treatment plan, but the remaining claims and interest were dismissed.
Accident benefits denied; physical impairments attributed to subsequent slip and fall and second accident.
He subsequently had a slip and fall and a second motor vehicle accident.
The Tribunal found that the applicant's psychological impairments were caused by the first accident, but he failed to prove that his physical impairments were caused by the first accident, as they were likely caused by the subsequent slip and fall or second accident.
The Tribunal dismissed the claims for physical treatment plans due to lack of causation.
The claims for psychological treatment and assessments were also dismissed because the applicant failed to prove they were reasonable and necessary, or failed to comply with the signature requirements under s. 38(3) of the Schedule.
Applicant's injuries found to be predominantly minor; claims for medical benefits beyond the MIG limit dismissed.
The insurer denied the claims on the basis that the applicant's injuries were predominantly minor and subject to the $3,500 funding limit under the Minor Injury Guideline (MIG).
The applicant argued that she sustained psychological injuries and chronic pain that removed her from the MIG.
The Tribunal found that the applicant's psychological evidence was refuted by the insurer's expert and contemporaneous medical records, and that she did not meet the criteria for chronic pain.
The Tribunal concluded that the applicant's injuries were predominantly minor, and therefore she was not entitled to the claimed medical benefits or interest.
Arbitrator awards income replacement and medical benefits, finding minor accident materially contributed to chronic pain.
The applicant was involved in a minor rear-end motor vehicle accident and subsequently claimed statutory accident benefits, including income replacement, housekeeping, and medical/rehabilitation benefits.
The insurer denied the claims, arguing the applicant's chronic pain and psychological impairments were not caused by the accident.
The arbitrator applied the material contribution test and found the accident exacerbated the applicant's pre-existing conditions, causing permanent impairment to her right shoulder and psychological disorders.
The applicant was awarded income replacement benefits, certain medical and assessment costs, and interest, but her claim for housekeeping benefits was dismissed due to insufficient credible evidence.
Income replacement benefits awarded for a limited period due to applicant's failure to mitigate psychological impairment.
The applicant was injured in a motor vehicle accident and received income replacement benefits until the insurer terminated them on July 9, 1998.
The applicant sought arbitration, claiming ongoing physical and psychological impairments prevented him from returning to his pre-accident employment as a cabinet assembler.
The arbitrator found that the applicant's physical soft tissue injuries had resolved and that he magnified his physical symptoms.
However, the arbitrator accepted that the applicant suffered from depression, anxiety, and pain-focused behavior that disabled him from working.
The arbitrator concluded that the applicant's failure to attend recommended psychological treatment and exercise hampered his recovery, and that by December 9, 1998, his ongoing inability to work was due to his own choice not to rehabilitate himself.
Income replacement benefits were awarded for the period from July 9, 1998, to December 9, 1998.
No linked lawyers found.
No linked judges found.