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Psychological impairment removes applicant from Minor Injury Guideline; non-earner benefit and physical treatments denied.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits.
The respondent insurer denied several benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Licence Appeal Tribunal found that while the applicant's physical injuries were minor, his psychological impairments, including an adjustment disorder and depression, removed him from the MIG.
The Tribunal granted the treatment plans for a psychological assessment and psychological services.
However, the claims for a non-earner benefit, physiotherapy, and chiropractic treatments were dismissed, as the applicant failed to prove a complete inability to carry on a normal life or that the physical treatments were reasonable and necessary.
Psychological impairment removed applicant from Minor Injury Guideline; income replacement benefits denied due to continued employment.
The applicant sought statutory accident benefits following a motor vehicle accident.
The insurer denied certain benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that while the applicant's physical injuries were minor soft tissue strains, his psychological impairment, specifically a diagnosed driving phobia, removed him from the MIG.
The Tribunal dismissed the claim for income replacement benefits, finding the applicant continued to work full-time as a welder and failed to prove a substantial inability to perform his essential tasks.
Claims for chiropractic treatment were denied, but the Tribunal awarded costs for a psychological assessment, accident-related medication, and an ambulance expense, along with interest.
Application for accident benefits dismissed as injuries fell within the Minor Injury Guideline.
The applicant sought statutory accident benefits following a rear-end motor vehicle collision.
The respondent denied several treatment plans for chiropractic and psychological services on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant's physical injuries were uncomplicated soft tissue injuries and that she failed to establish any pre-existing conditions or psychological impairments that would remove her from the MIG.
As the $3,500 funding limit for minor injuries had been exhausted, the claims for the disputed treatment plans and interest were dismissed.
Application for accident benefits dismissed as treatment plans were not reasonable and necessary.
The applicant sought medical and rehabilitation benefits for chronic pain treatment and physiotherapy following a motor vehicle accident.
The respondent insurer denied the treatment plans on the basis that the applicant had reached maximum medical improvement.
The Licence Appeal Tribunal found that the applicant's medical evidence lacked precision and failed to link the proposed treatments to the accident or demonstrate how they would improve his function.
Relying on the respondent's medical assessors, who concluded the applicant's injuries had resolved, the Tribunal held the treatment plans were not reasonable and necessary.
The claim for a chronic pain assessment was also dismissed because the applicant failed to submit the required Treatment and Assessment Plan (OCF-18).
The application was dismissed in its entirety.
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