2 total
Application for accident benefits dismissed as injuries were predominantly minor with no functional impairment.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied several benefits, arguing the applicant's injuries fell within the Minor Injury Guideline and were subject to the $3,500 coverage limit.
The Tribunal found that the applicant's physical injuries were sprains and strains, which are defined as minor injuries.
The Tribunal preferred the psychological evidence indicating the applicant's psychological symptoms were subclinical and did not impair her function, supported by contemporaneous counselling records showing she maintained a normal, active lifestyle.
The Tribunal also rejected the argument that chronic pain removed the applicant from the minor injury limit, as there was no evidence of functional impairment.
Consequently, the claims for attendant care, treatment plans, and a non-earner benefit were dismissed.
Application for medical benefits dismissed as applicant failed to prove treatment plans were reasonable and necessary.
The applicant, a pedestrian injured in a 2013 motor vehicle accident, sought medical benefits for physical rehabilitation and chiropractic treatment from the respondent.
The respondent denied the benefits based on an insurer's examination which concluded the applicant had reached maximum medical recovery.
The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to provide sufficient objective medical evidence to prove the proposed treatment plans were reasonable and necessary.
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