Dr. R. Lubbers

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

The respondent denied medical benefits beyond the $3,500 limit, determining the injuries fell within the Minor Injury Guideline.

The applicant argued she suffered from chronic pain and psychological impairments exceeding the minor injury definition.

The Tribunal found the applicant failed to meet her evidentiary onus, as the medical evidence did not establish chronic pain or psychological impairments.

The application for treatment plans and an award for unreasonably withheld benefits was dismissed.

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

The insurer determined the injuries fell within the Minor Injury Guideline (MIG) and denied treatment plans for physiotherapy and a psychological assessment.

The Tribunal found the applicant failed to provide compelling evidence of psychological injuries, chronic pain, or pre-existing conditions that would warrant removal from the MIG.

The Tribunal concluded the applicant sustained predominantly minor injuries, is subject to the $3,500 funding limit, and is not entitled to the disputed treatment plans, interest, or an award.

The applicant was struck by a vehicle while pushing her infant in a grocery cart and sought a determination of catastrophic impairment due to psychological injuries, along with ongoing Income Replacement Benefits (IRBs) and medical benefits.

The Tribunal found that while the applicant suffered a mental or behavioural disorder caused by the accident, her impairments were moderate rather than marked, and thus she did not meet the catastrophic impairment threshold.

However, the Tribunal granted the applicant's claim for post-104 week IRBs, finding she suffered a complete inability to engage in suitable employment based on vocational and psychological assessments.

Claims for specific physiotherapy and chiropractic treatment plans were dismissed for lack of evidence, though the insurer was ordered to pay HST on an approved psychological treatment plan.

A claim for a special award was dismissed.

The applicant was injured in a motor vehicle accident and sought approval for a multi-disciplinary catastrophic impairment assessment totaling $22,416.69.

The respondent partially approved the treatment plan for $7,006.00.

The applicant applied to the Licence Appeal Tribunal for the unapproved balance of $15,410.69.

The adjudicator found that most of the disputed assessments were either duplicitous, ancillary to the psychological assessment, or exceeded the $2,000 statutory cap per assessment under s. 25(5)(a) of the Schedule.

The applicant was awarded $2,000 for the CAT Rating/Executive Summary and $200 for the OCF-19 completion fee, plus interest, with the remainder of the claim dismissed.

The applicants, a husband and wife, were injured in a motor vehicle accident and sought statutory accident benefits from their insurer.

The insurer denied various claims for medical benefits, attendant care, and housekeeping.

At arbitration, the arbitrator awarded both applicants partial medical benefits for chiropractic treatment, finding the treatment reasonable and necessary given their chronic symptoms.

Claims for psychological counselling were denied due to a lack of objective evidence of improvement.

The wife was awarded attendant care and housekeeping benefits for a limited period based on in-home assessments by an occupational therapist.

The husband's claim for housekeeping benefits was dismissed as he was found capable of performing his pre-accident tasks.

The insurer was ordered to pay interest on the overdue benefits.