Dr. Roya Salehoun

The applicant sought statutory accident benefits following a motor vehicle accident, including an income replacement benefit (IRB) and removal from the Minor Injury Guideline (MIG) due to chronic pain and psychological impairments.

The Tribunal first determined that the applicant was not barred from proceeding despite failing to attend an insurer's examination, as the examination was requested months after the application was filed.

On the merits, the Tribunal found the applicant was not entitled to an IRB because she failed to prove a substantial inability to perform the essential tasks of her pre-accident employment as a customer service representative, having focused her evidence on her post-accident goal of becoming a hairdresser.

The Tribunal also held that the applicant's injuries remained within the MIG, rejecting her claims of chronic pain and psychological impairment due to insufficient medical evidence and methodological flaws in her expert's psychological assessment.

Finally, the Tribunal found the insurer's denial notices were compliant with the Schedule, dismissing the application in its entirety.

The applicant sought statutory accident benefits, including income replacement benefits (IRBs) and funding for seven physiotherapy treatment plans, following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application in its entirety.

The adjudicator found the applicant's self-reporting to medical assessors unreliable due to symptom magnification and surveillance evidence showing the applicant working long hours at a restaurant.

Consequently, the applicant failed to prove a substantial inability to perform the essential tasks of his employment for pre-104 week IRBs, or a complete inability to engage in any employment for post-104 week IRBs.

The physiotherapy plans were deemed not reasonable and necessary, as the applicant contemporaneously reported to his family doctor that the treatments were ineffective.

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

The insurer denied the benefits based on its assessors' reports, which concluded the applicant could return to his pre-accident employment as a heavy labourer.

The arbitrator found the applicant's evidence and his experts' reports more credible, noting the insurer's assessors lacked complete information and ignored the applicant's chronic pain.

The arbitrator held that the applicant met the test for IRBs both before and after the 104-week mark, as he suffered a complete inability to engage in suitable employment.

The requested medical benefits were also found to be reasonable and necessary.

However, the arbitrator dismissed the claim for a special award, finding the insurer did not act unreasonably in relying on its medical assessors, despite the flaws in their reports.