Dr. West

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for various psychological and physical 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 limit was exhausted.

The Tribunal found that the applicant failed to discharge his burden to prove his injuries warranted removal from the MIG.

The Tribunal preferred the respondent's psychological expert over the applicant's expert, noting the applicant's expert failed to address contradictory medical records.

As the MIG limits were exhausted, the treatment plans were not payable.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming catastrophic impairment under Criteria 7 and 8 of the Schedule due to vascular dementia and other impairments.

The respondent denied the benefits, noting the applicant had already reached the non-catastrophic funding limit.

The Licence Appeal Tribunal found that the applicant failed to meet the burden of proving catastrophic impairment, as the medical evidence did not establish a 55% whole person impairment under Criterion 7 or a marked impairment in three domains under Criterion 8.

Consequently, the claims for additional medical benefits, interest, and a section 10 award were dismissed.

The applicant sought statutory accident benefits following a 2016 motor vehicle accident.

The Licence Appeal Tribunal found the applicant was barred from claiming a non-earner benefit because he failed to dispute the insurer's denial within the two-year limitation period.

The Tribunal also held that the applicant's injuries fell within the Minor Injury Guideline (MIG), as he failed to establish a pre-existing condition, chronic pain with functional impairment, or a psychological condition that would warrant removal.

Consequently, the disputed treatment plans were denied, and no award or interest was payable.

The applicant sought a determination of catastrophic impairment and entitlement to income replacement benefits and medical benefits following a 2016 motor vehicle accident.

The Tribunal found that the accident was not a necessary cause of the applicant's right hip osteoarthritis aggravation or his psychological impairments, which were instead attributed to a post-accident stroke and subsequent loss of his driver's licence.

Consequently, the applicant did not meet the 55% whole person impairment threshold for catastrophic impairment.

The claims for income replacement benefits and medical assessments were also dismissed as the applicant failed to prove they were reasonable, necessary, or caused by the accident.

The applicant was injured in a motorcycle accident and sought attendant care benefits (ACBs) of $6,000 per month, claiming a need for 24-7 supervision due to physical, cognitive, and psychological impairments.

The respondent argued the applicant only required just under four hours of care per day.

The Tribunal found the applicant's evidence regarding cognitive decline unreliable and noted limitations in both parties' occupational therapy assessments.

Taking a practical approach based on the evidence, the Tribunal determined the applicant did not require 24-7 supervision but was entitled to ACBs in the amount of $2,724.28 per month.

This costs endorsement addresses the appropriate quantum of costs following a motor vehicle accident trial in which the plaintiff was awarded damages by the jury, but the award was reduced to zero by operation of the Insurance Act.

The defendant sought $269,264.87 in costs, later reducing the request to $230,000.

The plaintiff argued for a much lower award, citing financial hardship and litigation conduct.

The court fixed costs at $185,000, finding the defendant entitled to costs but reducing the amount for duplication, lack of particulars, and proportionality.

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 argued she should be removed from the MIG due to a pre-existing condition of mild scoliosis and chronic pain with a functional impairment.

The Tribunal found that the applicant failed to provide compelling medical evidence that her pre-existing condition precluded recovery within the MIG.

Furthermore, applying the AMA Guidelines, the Tribunal concluded the applicant did not suffer from chronic pain with a functional impairment, as she remained independent in her activities of daily living and continued to work.

As the applicant remained within the MIG limit, the disputed treatment plans were not assessed for reasonableness and necessity.

The application was dismissed.

This trial judgment addresses spousal and child support claims following a long-term marriage.

The court determined the reasonableness of the respondent husband's early retirement, declining to impute his pre-retirement income due to mental health and caregiving responsibilities for a disabled child.

The court imputed a modest part-time income to the husband and a modest investment income to the applicant wife from her equalization payment.

It rejected the applicant's claim for retroactive spousal support and the concept of "double-recovery" from the husband's pension, finding the husband to be in greater financial hardship.

Prospective spousal support was awarded at the high end of the Spousal Support Advisory Guidelines based on the imputed incomes.

Child support for the adult child was terminated.

The applicant, a pedestrian struck by a vehicle, sought statutory accident benefits including a catastrophic impairment designation under Criterion 4, income replacement benefits, and various treatment plans.

The adjudicator found the applicant did not meet the test for catastrophic impairment, preferring the respondent's neurologist who concluded there was no diagnostic evidence of brain trauma from the accident.

Claims for income replacement benefits and a central vacuum system were dismissed, while treatment plans for physiotherapy and occupational therapy were approved as reasonable and necessary.

Requests for costs by both parties were denied.

The applicant sought a determination that she sustained a catastrophic impairment as a result of a 2018 motor vehicle accident, along with entitlement to various treatment plans.

The Tribunal found the applicant did not meet the threshold for catastrophic impairment under either criterion 7 (whole person impairment) or criterion 8 (mental or behavioural impairment), rejecting the impairment ratings proposed by her assessors due to a lack of objective evidence and causal connection to the accident.

However, the Tribunal concluded that a $13,386.90 multidisciplinary chronic pain program was reasonable and necessary to address the applicant's ongoing pain-related complaints.

The claims for psychological services, a neuropsychology assessment, and transportation expenses were dismissed as the applicant failed to provide submissions or meet her evidentiary burden.

The appellant appealed a Licence Appeal Tribunal decision that found she was not catastrophically impaired following a motor vehicle accident.

The Divisional Court allowed the appeal, finding the Tribunal breached procedural fairness in three ways: relying on the untested evidence of the respondent's expert who did not re-attend for cross-examination, deciding the issue of causation without notice when it was not in dispute, and relying on documents not in evidence that the appellant had no opportunity to address.

The matter was remitted to the Tribunal for a new hearing.

The applicant sought statutory accident benefits following a 2017 motor vehicle accident, claiming catastrophic impairment due to mental and behavioural disorders.

The Licence Appeal Tribunal found the applicant sustained a catastrophic impairment under criterion 8, demonstrating marked impairments in activities of daily living, concentration, persistence and pace, and adaptation.

The Tribunal preferred the evidence of the applicant's psychological assessor over the insurer's assessor.

The applicant was also awarded entitlement to six disputed treatment plans for case management services, along with interest on overdue payments.

The insurer requested a reconsideration of a decision finding that the claimant sustained a catastrophic impairment.

The insurer argued the adjudicator erred in law and fact by accepting a neuropsychological assessment where the Extended Glasgow Outcome Scale (GOS-E) was administered by an occupational therapist rather than the neuropsychologist.

The adjudicator dismissed the request, finding no error of law because the Schedule permits a neuropsychologist to be assisted by other regulated health professionals.

While acknowledging a factual error regarding whether the insurer's assessor administered the GOS-E, the adjudicator concluded this error would not have changed the result, as the claimant's expert evidence was more consistent with the medical record.

The appellant appealed a Licence Appeal Tribunal decision finding he had not suffered a catastrophic impairment following a motor vehicle accident.

The appellant argued the adjudicator erred in her treatment of expert evidence, violated procedural fairness by questioning an expert, misapplied the temporal requirements for assessments under the Statutory Accident Benefits Schedule, and used an overly restrictive causation test.

The Divisional Court dismissed the appeal, finding no errors of law, as the adjudicator properly applied a flexible approach to the timing of assessments and correctly considered impairments caused by the traumatic brain injury.

This trial ruling addresses the admissibility and content of Ms. Pollard's summary charts for future care costs in two personal injury actions.

The court clarified the scope of Ms. Pollard's expert qualifications, limiting her opinions to unit costs and excluding recommendations on specific treatments, dosages, or frequencies unless supported by qualified medical evidence.

The ruling provides guidance on what items can be included in the summary charts for jury consideration, emphasizing the need for "reasonable evidence" and distinguishing between expert opinion and jury common sense.

The applicant was involved in a motorcycle accident and sustained a traumatic brain injury.

He applied for a catastrophic impairment determination under Criterion 4 of the Statutory Accident Benefits Schedule, relying on the Extended Glasgow Outcome Scale (GOS-E).

The adjudicator found that the applicant met the threshold for a lower moderate disability, primarily due to his inability to return to work in his previous capacity, and thus qualified for catastrophic impairment status.

The adjudicator also awarded partial attendant care benefits and approved several treatment plans for occupational therapy, psychological services, and a laptop, while denying other claimed medical benefits and a claim for a special award.

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

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

The Tribunal found that the applicant suffered from chronic pain syndrome, satisfying three of the six criteria under the AMA Guides, and was therefore removed from the MIG.

The Tribunal approved two physiotherapy treatment plans and partially approved an attendant care assessment, finding them reasonable and necessary.

However, claims for psychological treatment and assessments were dismissed due to a lack of corroborating evidence.

The applicant was awarded interest on the overdue benefits but denied an award under Regulation 664, as the insurer's conduct was not found to be unreasonable.

The applicant requested a reconsideration of a decision finding he did not sustain a catastrophic impairment as a result of a minor traumatic brain injury from a motor vehicle accident.

The applicant argued the adjudicator erred in law regarding the temporal analysis of the GOS-E, by discrediting his neuropsychologist's report because an occupational therapist conducted the GOS-E interview, and by failing to weigh the respondent's occupational therapist's observations.

The adjudicator dismissed the request, finding no error of law or fact.

The adjudicator affirmed that a flexible approach to the timing of the GOS-E is appropriate, that the GOS-E interview must be conducted by a physician or neuropsychologist, and that occupational therapists cannot opine on whether impairments are caused by a brain injury versus other injuries.

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

The respondent denied several treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant's physical injuries were predominantly minor and did not warrant removal from the MIG, dismissing claims for physiotherapy, chiropractic services, and orthopaedic/neurological assessments.

However, the Tribunal preferred the applicant's psychological evidence over the respondent's section 44 assessor, finding that the applicant suffered from severe depression and anxiety directly resulting from the accident.

Consequently, the applicant was removed from the MIG on psychological grounds, and the treatment plans for a psychological assessment and psychological treatment were deemed reasonable and necessary, with interest payable.

The applicant requested a reconsideration of a Tribunal decision that found his injuries fell within the Minor Injury Guideline and denied his claim for income replacement benefits.

The applicant argued the adjudicator ignored relevant caselaw, failed to declare the Minor Injury Guideline of no force and effect, misapplied the 'but for' test for causation, and erred in preferring the respondent's psychological expert over his own.

The Tribunal dismissed the request, finding no violation of procedural fairness or errors of law.

The constitutional challenge lacked required notice, the causation test was correctly applied to find dizziness was pre-existing, and the adjudicator was entitled to prefer the in-person expert assessment over a telephone-based report containing factual errors.