Dr. Patrick Tansey

The applicant sought statutory accident benefits following a May 2020 motor vehicle accident.

The respondent denied treatment plans for chiropractic, psychological, and psychiatric services on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant failed to establish that she suffered from accident-related chronic pain with functional impairment or a psychological condition that would warrant removal from the MIG, noting a subsequent accident in June 2024 complicated causation.

The Tribunal also found the respondent's denial letters complied with section 38(8) of the Schedule.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident.

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's documented pre-existing chronic pain condition and accident-related psychological impairments warranted removal from the MIG.

The Tribunal ordered the respondent to pay for the disputed attendant care, chiropractic, and psychological treatment plans, along with interest, but denied the claim for assistive devices and a special award for unreasonable delay.

The applicant sought entitlement to several treatment and assessment plans (OCF-18s) under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The respondent insurer denied the plans based on insurer's examinations indicating the applicant had reached maximum medical improvement or that her symptoms were related to pre-existing conditions.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to meet her burden of proving the disputed plans were reasonable and necessary.

The Tribunal noted a lack of objective medical evidence supporting the requested treatments and found the applicant's submissions often failed to address the specific goals and costs of the proposed plans.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to an income replacement benefit (IRB), chiropractic treatment plans, and an orthopaedic assessment.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to prove a substantial inability to perform his essential work tasks within 104 weeks of the accident, or a complete inability to work thereafter.

The Tribunal preferred the evidence of the insurer's examiners over the applicant's assessors, noting the lack of corroborating medical evidence for the applicant's claimed impairments.

The claims for treatment plans and assessments were also dismissed as the applicant failed to establish they were reasonable and necessary.

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.

The applicant was injured in a rear-end motor vehicle accident and sought medical and rehabilitation benefits beyond the $3,500 Minor Injury Guideline (MIG) limit, arguing that a pre-existing clavicle fracture was exacerbated, leading to chronic pain and psychological impairments.

The adjudicator found that the applicant failed to provide compelling evidence of functional impairment or disability resulting from chronic pain, noting that he continued to work and travel, and did not meet the criteria under the AMA Guides.

The adjudicator concluded that the applicant's injuries were predominantly minor and subject to the MIG limit.

As the MIG limit had been exhausted, the disputed treatment plans were denied and the application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent denied the claims on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant's physical injuries, including neck and back strain, were predominantly minor.

The Tribunal also found that the applicant did not suffer a psychological impairment that would remove her from the MIG, preferring the respondent's psychological assessment over the applicant's due to the latter's failure to consider relevant clinical notes and the applicant's non-disclosure of alcohol use.

The application for medical and rehabilitation benefits and interest was dismissed.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for a multi-disciplinary chronic pain management treatment plan and two physiotherapy treatment plans.

The adjudicator found the chronic pain management treatment plan to be reasonable and necessary, relying on the applicant's orthopaedic expert who established a direct causal relationship between the accident and the applicant's severe chronic pain.

However, the adjudicator dismissed the claims for the physiotherapy treatment plans, noting that the applicant had reached maximal medical recovery from a musculoskeletal perspective and that the chronic pain program already included multiple body sites therapy.

The applicant was awarded interest on the overdue chronic pain benefit.

The applicant sought dispute resolution after the respondent insurer denied treatment plans for psychological, chiropractic, and massage services following a motor vehicle accident.

The insurer argued the applicant's injuries fell within the Minor Injury Guideline (MIG).

The adjudicator found that the applicant's ongoing pain complaints, supported by medical evidence, established a chronic pain condition that removed him from the MIG.

However, the adjudicator concluded that the applicant failed to prove the disputed treatment plans were reasonable and necessary, as there was insufficient objective medical evidence supporting the need for psychological or chiropractic intervention.

The claims for the treatment plans, a special award, and interest were dismissed.

The applicant sought medical benefits for physiotherapy, chiropractic, and massage therapy services following a motor vehicle accident.

The respondent denied the treatment plan based on an insurer's examination.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove the treatment was reasonable and necessary.

The Tribunal preferred the evidence of the respondent's orthopedic surgeon, who concluded the applicant had reached maximum medical recovery and would not benefit from further facility-based treatment, over the applicant's medical records which showed limited improvement.

The applicant sought income replacement benefits (IRBs) for a one-month period during which she returned to work on modified hours following a motor vehicle accident.

The insurer had terminated IRBs based on insurer examinations concluding the applicant did not suffer a substantial inability to perform her pre-accident employment.

The Tribunal found the insurer's medical evidence more persuasive than the applicant's family doctor's records, noting the applicant had successfully returned to full-time work.

The Tribunal dismissed the claim for IRBs and interest, and denied the insurer's request for costs.

The applicant, a 14-year-old high school student, sustained a mild traumatic brain injury when she was struck by a car as a pedestrian.

She applied for non-earner benefits, which the insurer terminated after 104 weeks.

The arbitrator found that the applicant's post-accident life was significantly altered by cognitive fatigue, reduced processing speed, and anxiety, requiring extensive accommodations and therapy to complete high school.

Rejecting the insurer's medical assessments, the arbitrator concluded the applicant suffered a complete inability to carry on a normal life and awarded ongoing non-earner benefits and interest.