Dr. S. McDowall

The applicant sought statutory accident benefits following a motor vehicle accident, claiming his psychological injuries and pre-existing conditions warranted treatment outside the Minor Injury Guideline (MIG).

The respondent denied the benefits, arguing the injuries were minor.

The Tribunal found that the applicant's pre-existing back pain and anxiety did not preclude his recovery within the MIG.

Furthermore, the Tribunal preferred the respondent's psychological assessment, finding the applicant's anxiety and depression were primarily related to personal stressors rather than the accident.

The application was dismissed, and the applicant was held to the $3,500 MIG funding limit.

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

The respondent denied the claims, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant failed to establish a psychological impairment warranting removal from the MIG.

However, the Tribunal determined that the respondent's denial notices for the disputed treatment plans failed to comply with the requirements of s. 38(8) of the Schedule, as they lacked sufficient medical reasons.

Consequently, under s. 38(11), the treatment plans were deemed payable once incurred.

The Tribunal awarded interest on the overdue benefits but declined to order a special award under s. 10 of O. Reg. 664.

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

The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant sought removal from the MIG based on chronic pain and psychological impairments.

The Tribunal found the applicant failed to meet the burden of proving chronic pain with functional impairment or a psychological condition warranting removal.

The Tribunal also found the respondent's denial letters were compliant with s. 38(8) of the Schedule, as the applicant failed to comply with s. 33 requests for information.

The application was dismissed.

The applicant sought removal from the Minor Injury Guideline (MIG) following a motor vehicle accident, claiming a psychological impairment.

The Tribunal found the applicant's psychological evidence unpersuasive, noting inconsistencies in the expert report and standard test results indicating minimal depression and anxiety.

The Tribunal concluded the applicant failed to prove a psychological impairment warranting removal from the MIG and denied the disputed treatment plans beyond the $3,500 limit.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the insurer's determination that his injuries fell within the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG based on psychological injuries and chronic pain.

The Tribunal found that the applicant's physical injuries had resolved, noting his return to strenuous physical activity like boxing.

The Tribunal also rejected the psychological and chronic pain claims, giving little to no weight to the applicant's expert reports due to methodological flaws and inconsistencies with the clinical records.

As the applicant failed to prove his injuries warranted removal from the MIG and the $3,500 limit was exhausted, the application for disputed treatment plans and interest was dismissed.

The applicant sought statutory accident benefits for psychological treatment and catastrophic impairment assessments following a 2018 motor vehicle accident.

The Licence Appeal Tribunal dismissed the application.

The claim for psychological treatment was barred by res judicata, having been denied in a previous Tribunal decision.

The claim for catastrophic assessments was denied because the applicant failed to demonstrate that her pre-existing osteoarthritis or psychological symptoms were exacerbated by or directly related to the accident, relying instead on self-reported assessments that contradicted her family physician's contemporaneous records.

The Applicant, a pedestrian struck by a vehicle, sought non-earner benefits and funding for a catastrophic impairment assessment from her insurer.

The Licence Appeal Tribunal dismissed the application, finding the Applicant failed to prove she suffered a complete inability to carry on a normal life.

The Tribunal gave no weight to the Applicant's medical reports due to inconsistencies and failure to address pre-existing conditions from a prior accident.

Conversely, the insurer's examination reports, which found no residual impairment, were accepted.

The request for a catastrophic impairment assessment was also denied as not reasonable and necessary.

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

The respondent denied certain treatment plans and assessments, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant sustained a psychological impairment, removing him from the MIG.

The Tribunal ordered the respondent to pay for a psychological assessment, a chronic pain assessment, and portions of the proposed psychological treatment and chronic pain program, along with interest.

The applicant's claim for a special award under s. 10 of Regulation 664 was dismissed.

The Applicant sought income replacement benefits (IRBs) and medical benefits following a low-speed motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding that the Applicant failed to provide contemporaneous medical evidence demonstrating a substantial inability to perform the essential tasks of his employment as a cleaning company manager.

The Tribunal relied on insurer's examination reports which found no functional impairments or severe emotional symptomology.

Claims for physiotherapy, psychological services, and an occupational therapy assessment were also dismissed as not reasonable and necessary.

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

The respondent denied certain benefits, including a psychological assessment and treatment plans, on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit had been exhausted.

The applicant argued for removal from the MIG due to chronic pain and psychological impairment.

The Tribunal found insufficient medical evidence to support chronic pain, noting the family physician's records did not contain such a diagnosis.

The Tribunal also gave little weight to the applicant's psychological assessment, as the assessors did not review the family physician's clinical notes, which showed no post-accident psychological complaints.

The Tribunal concluded the injuries were predominantly minor, the MIG applied, and dismissed the application for the disputed benefits.

The applicant sought statutory accident benefits for two chiropractic treatment plans totaling over $17,000 following a motor vehicle accident.

The respondent insurer denied the plans on the basis that the physical injuries were soft tissue in nature and resolved, noting a prior workplace injury to the same areas.

The Tribunal found that the applicant failed to prove the treatment plans were reasonable and necessary, citing inconsistencies in the medical records, a two-year gap in treatment, and the significant role of the prior workplace injury.

The application was dismissed.

The applicant, a pedestrian struck by a motor vehicle, sought statutory accident benefits for physical and psychological impairments.

The Licence Appeal Tribunal found that the applicant's injuries were predominantly minor and subject to the $3,500 limit under the Minor Injury Guideline (MIG).

The applicant failed to establish that chronic pain or psychological impairments warranted removal from the MIG.

Consequently, claims for physiotherapy, acupuncture, and a psychological assessment were dismissed.

A claim for medication expenses incurred in China was also dismissed for failing to comply with the Schedule's requirements.