Dr. Paul Stacey

The applicant sought statutory accident benefits following a motor vehicle accident, specifically a chronic pain assessment.

The respondent denied the benefit, arguing the applicant's fibromyalgia predated the accident and she was not in active treatment.

Procedurally, the adjudicator dismissed the respondent's motion to admit late insurer examination reports, finding it would prejudice the applicant.

The adjudicator also denied the respondent's request to file a sur-reply.

On the merits, the adjudicator found the chronic pain assessment to be reasonable and necessary, preferring the evidence of the applicant's pain management specialist and noting that the respondent's own multidisciplinary assessment corroborated the applicant's symptoms.

The adjudicator awarded the disputed treatment plan with interest, but declined to award costs to either party, finding no unreasonable or bad faith conduct.

The applicant sought statutory accident benefits for chiropractic and physiotherapy treatment plans following a 2019 motor vehicle accident.

The respondent insurer denied the plans based on an insurer's examination which concluded the applicant sustained only soft tissue injuries and did not require further facility-based treatment.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to provide sufficient medical evidence, such as clinical notes or progress reports, to demonstrate that the proposed treatments were reasonable and necessary.

The applicant sought medical and rehabilitation benefits under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The respondent insurer denied treatment plans for psychological services, physiotherapy, and vision therapy based on the opinions of its assessors.

The Licence Appeal Tribunal found that the applicant met her burden of proving the treatments were reasonable and necessary, preferring the evidence of her treating practitioners over the respondent's assessors.

The Tribunal ordered the respondent to pay $16,870.79 for the disputed treatment plans plus interest, but declined to make a special award under Regulation 664.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including income replacement benefits (IRBs) and medical/rehabilitation benefits.

The Licence Appeal Tribunal found that the applicant did not suffer a substantial inability to perform the essential tasks of her pre-accident employment as a caregiver, nor a complete inability to engage in any employment post-104 weeks, and thus denied the IRBs.

However, the Tribunal found the claimed treatment plans for chiropractic, massage, physiotherapy, and mental health therapy to be reasonable and necessary due to objective evidence of physical and psychological impairments caused by the accident.

The medical benefits and interest on overdue payments were awarded.