Dr. R. Soric

The applicant was involved in a motor vehicle accident and sought funding for chiropractic treatment plans.

The respondent denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 funding limit had been exhausted.

The applicant argued that her consistent headaches and neck/back pain warranted removal from the MIG.

The Tribunal found that the medical evidence, including reports from a neurologist and physiatrist, supported a diagnosis of tension/cervicogenic headaches and neck/back strains, which fall under the definition of a minor injury.

The applicant failed to establish on a balance of probabilities that her injuries warranted removal from the MIG.

As the MIG limit was exhausted, the treatment plans and claim for interest were dismissed.

The Applicant sought various medical, rehabilitation, and attendant care benefits following a motor vehicle accident, as well as an award for unreasonable delay.

The Licence Appeal Tribunal dismissed the application in its entirety.

The Adjudicator found that the Applicant failed to meet her burden of proving that the proposed chiropractic, physiotherapy, psychological, and occupational therapy treatment plans were reasonable and necessary.

The Adjudicator preferred the evidence of the insurer's examination assessors, who found no objective evidence of ongoing musculoskeletal impairment and noted a lack of response to past physical treatments.

Claims for attendant care benefits and an award were also dismissed due to a lack of supporting evidence.

The applicant sought statutory accident benefits following a rear-end motor vehicle accident, including ongoing income replacement benefits (IRBs) and various treatment plans.

The Licence Appeal Tribunal dismissed the application, preferring the respondent's insurer examination reports which found no physical, neurological, or psychological impairments preventing the applicant from working.

The Tribunal also noted the applicant's family doctor refused to complete IRB forms due to a lack of ongoing symptoms.

The claims for medical assessments and treatment plans were denied as they were not reasonable and necessary, and had not been incurred.

The applicant claimed she was injured in a minor motor vehicle accident and sought income replacement benefits and housekeeping expenses from her insurer.

The insurer denied the claims, arguing the collision was too minor to cause the alleged injuries and questioning the applicant's credibility.

The arbitrator found the applicant's evidence unreliable, noting numerous inconsistencies and implausible explanations regarding the accident and her injuries.

The arbitrator concluded the applicant did not suffer a substantial inability to perform her employment tasks or housekeeping duties as a result of the accident.

All claims for benefits and a special award were dismissed.

The applicant sought income replacement benefits, non-earner benefits, and medical expenses following a motor vehicle accident.

The arbitrator found that the applicant fabricated his pre-accident employment and was therefore not entitled to income replacement benefits.

The claim for non-earner benefits was dismissed as the applicant failed to prove a complete inability to carry on a normal life.

The arbitrator also held that the applicant's failure to attend a Designated Assessment Centre (DAC) barred him from recovering medical expenses incurred after the scheduled assessment date, but he was entitled to reasonable and necessary expenses incurred prior to that date.

The applicant was injured in a motor vehicle accident and applied for statutory accident benefits.

The insurer terminated income replacement benefits and, over four years later, requested that the applicant undergo a medical examination by an orthopaedic surgeon under section 42 of the Statutory Accident Benefits Schedule.

The applicant refused, arguing the examination was not reasonably necessary.

The arbitrator found that the insurer had already conducted multiple assessments by other specialists, including a neurosurgeon and an occupational medicine physician, none of whom recommended an orthopaedic evaluation.

The insurer failed to establish that the proposed examination was reasonably necessary or that its previous assessments were not meaningful evaluations of the applicant's physical condition.

The insurer's request was denied, and the applicant was awarded the expenses of the preliminary issue hearing.

The applicant was injured in a motor vehicle accident and sought payment for chiropractic and rehabilitation treatments from his automobile insurer.

The insurer disputed the necessity and cost of the treatments, and argued that the applicant's extended health insurer was the primary payer.

The arbitrator held that the legal burden of proof lies with the insured to demonstrate what collateral benefits were reasonably available and what balance remains owing by the automobile insurer.

The arbitrator found the treatments were reasonable and necessary, adjusted the allowable costs, and ordered the insurer to pay the outstanding balance of $993.

A special award of $250 was also granted against the insurer for unreasonably delaying payment.

The applicant was injured in a motor vehicle accident and received statutory accident benefits until the insurer terminated her income replacement and housekeeping benefits.

The applicant applied for arbitration, claiming ongoing entitlement to income replacement benefits, loss of earning capacity benefits, physiotherapy, and housekeeping expenses.

The arbitrator found that the applicant suffered a substantial inability to perform the essential tasks of her employment due to chronic pain, despite a lack of objective musculoskeletal findings, and ordered the insurer to pay income replacement benefits and make an offer for loss of earning capacity benefits.

The claims for physiotherapy and housekeeping expenses were dismissed due to a lack of supporting evidence.

The Applicant was injured in a motor vehicle accident and received statutory accident benefits until the Insurer terminated them.

The Applicant sought arbitration for ongoing weekly income benefits, medical and rehabilitation benefits, and a special award.

The arbitrator found that the Applicant suffered from chronic pain and soft tissue injuries that prevented her from returning to full-time work, entitling her to ongoing weekly income benefits and specific rehabilitation benefits, including ergonomic equipment for a home office.

The arbitrator denied the Insurer's request for repayment of chiropractic expenses and denied the Applicant's request for a special award, finding the Insurer's actions were not unreasonable.