Dr. Tansey

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

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

The Tribunal found the applicant suffered from chronic pain with functional impairments, warranting removal from the MIG.

The Tribunal approved treatment plans for physiotherapy, a chronic pain assessment, and a psychological assessment, finding them reasonable and necessary based on medical evidence and contemporaneous reporting.

A treatment plan for an orthopaedic assessment was denied as the applicant failed to establish it was warranted.

The applicant was also awarded interest on overdue benefits.

The applicant sought a non-earner benefit (NEB) under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The respondent insurer denied the benefit, arguing the applicant's post-accident condition was not significantly different from his pre-accident state due to extensive pre-existing injuries.

The Tribunal applied the Heath test and found that the accident exacerbated the applicant's chronic pain and mobility issues, resulting in a complete inability to carry on a normal life.

The Tribunal gave limited weight to the insurer's s. 44 assessors because they failed to review the applicant's medical records.

The applicant was awarded the NEB with interest.

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

The respondent denied further treatment plans and attendant care benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline and the $3,500 funding limit had been exhausted.

The Tribunal found that the applicant's soft tissue injuries were properly classified as minor, preferring the respondent's orthopedic assessment over the brief clinical notes of the applicant's osteopath.

As the funding limit was exhausted and minor injuries do not qualify for attendant care, the application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including treatment plans for physiotherapy, a chronic pain assessment, assistive devices, and psychological services.

The Tribunal dismissed the claims for physiotherapy, chronic pain assessment, and psychological services, finding the applicant's evidence inconsistent and relying on surveillance showing her performing activities she claimed she could not do.

The Tribunal granted the treatment plan for assistive devices, as both parties' occupational therapists recommended them.

Claims for a special award and costs were dismissed.

The applicant was injured in a motor vehicle accident and sought payment for two chiropractic treatment plans for chronic shoulder pain.

The respondent insurer denied the plans based on an insurer's examination report.

The Tribunal found the treatment plans reasonable and necessary, preferring the evidence of the applicant's treating physicians and chronic pain program over the insurer's assessor.

The Tribunal also awarded a 10% special award under s. 10 of O. Reg. 664, finding the respondent unreasonably withheld benefits by failing to adjust the claim when presented with updated medical records.

The applicant, a pedestrian injured in a motor vehicle accident, sought a medical benefit of $1,553.60 for a treatment plan after being removed from the Minor Injury Guideline.

The respondent denied the claim based on an insurer's examination by an orthopaedic surgeon who concluded the treatment was not reasonable and necessary.

The Tribunal dismissed the application, finding the applicant failed to provide sufficient medical evidence to support the treatment plan and that the respondent did not engage in unfair practices or unreasonably delay the claim.

The applicant sought income replacement benefits (IRBs) and various medical benefits following a motor vehicle accident.

The insurer terminated IRBs and denied further medical benefits on the basis that the applicant's injuries were predominantly minor and the $3,500 Minor Injury Guideline (MIG) limit had been exhausted.

The Tribunal found that the applicant did not suffer a substantial inability to perform the essential tasks of her pre-accident employment, relying on insurer examinations that showed her impairment was temporary and self-limited.

The Tribunal also held that the applicant failed to provide compelling medical evidence that her pre-existing conditions prevented her from achieving maximal recovery under the MIG.

The application was dismissed.

The applicants, a mother and son, sought statutory accident benefits following a motor vehicle accident.

The mother claimed caregiver, housekeeping, and medical benefits, while the son claimed income replacement and medical benefits.

The arbitrator dismissed all claims, finding severe credibility issues with both applicants' evidence.

The mother's testimony regarding the children she cared for, her residential address, and her employment of a caregiver was riddled with inconsistencies and contradicted by documentary evidence.

The son's evidence regarding his pre-accident employment and income was also found to be unreliable.

The insurer's medical assessments, which concluded the son's injuries fell within the Minor Injury Guideline, were accepted.