12 total
Applicant remains subject to the Minor Injury Guideline as claims of concussion and chronic pain were unproven.
The applicant sought statutory accident benefits following a motor vehicle accident, claiming his injuries—including a concussion, chronic pain, and a psychological condition—warranted removal from the Minor Injury Guideline (MIG).
The Licence Appeal Tribunal found that the applicant failed to prove on a balance of probabilities that he sustained injuries falling outside the MIG.
The Tribunal preferred the respondent's expert medical evidence, which concluded the applicant suffered only minor injuries such as whiplash and a sprained shoulder.
Consequently, the applicant remained subject to the $3,500 MIG limit, and his claims for additional treatment plans, interest, and a special award were dismissed.
Application for accident benefits dismissed; applicant failed to prove entitlement to removal from Minor Injury Guideline.
The applicant sought statutory accident benefits following a motor vehicle accident, disputing the insurer's determination that her injuries fell within the Minor Injury Guideline (MIG).
The applicant argued for removal from the MIG based on a pre-existing right-leg fracture and an accident-related psychological impairment.
The Tribunal found that the applicant failed to provide compelling medical evidence that her pre-existing condition prevented maximal recovery within the MIG.
Furthermore, the Tribunal afforded little weight to the applicant's psychological assessment due to a lack of corroborating medical records and reliability issues.
As the applicant remained within the MIG, her claims for disputed treatment plans, interest, and an award were dismissed.
Application for accident benefits dismissed; applicant's injuries remained within the Minor Injury Guideline.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied a chiropractic treatment plan on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant's diagnosed whiplash and strains were minor injuries under the Schedule.
The applicant failed to prove that pre-existing conditions prevented maximal medical recovery within the MIG, and subsequent imaging occurred after a second motor vehicle accident.
The application was dismissed, and the applicant remained subject to the $3,500 MIG limit.
Application for accident benefits dismissed; proposed chiropractic and massage treatment plans not reasonable and necessary.
The applicant sought entitlement to six treatment plans for chiropractic services, massage therapy, and physical therapy following a 2019 motor vehicle accident.
The Licence Appeal Tribunal found that the applicant failed to provide sufficient corroborating medical evidence to prove the disputed treatments were reasonable and necessary, noting a lack of objective improvement in range of motion.
The Tribunal accepted the respondent's orthopaedic independent medical examinations, which concluded that only active therapies were reasonable and that the applicant had reached maximal medical recovery from facility-based treatment.
The Tribunal also found the respondent's denial letters complied with section 38(8) of the Schedule.
The application was dismissed.
Applicant's delay in applying for accident benefits excused due to traumatic brain injury and memory loss.
The applicant was injured in a motor vehicle accident while cycling and sought statutory accident benefits.
The respondent denied benefits, arguing the applicant failed to notify them of his intention to apply within the prescribed timelines under section 32(1) of the Schedule.
The Tribunal found that the applicant had a reasonable explanation for the delay, as he suffered a traumatic brain injury with memory loss and likely did not remember receiving information about accident benefits.
The Tribunal concluded that the hardship to the applicant outweighed any prejudice to the respondent, allowing the application to proceed.
Minor's $20,000 personal injury settlement and 30% contingency fee approved as fair and reasonable.
The minor plaintiff was struck by a vehicle and sustained non-catastrophic injuries, including a head injury that largely resolved.
The plaintiff, through his litigation guardian, brought a motion under Rule 7 to approve a $20,000 settlement.
The court reviewed updated medical evidence confirming the minor's recovery and found the settlement, along with the proposed contingency fees and disbursements, to be fair and reasonable.
The motion was granted and the settlement was approved.
Application for accident benefits dismissed; applicant failed to prove injuries fell outside the Minor Injury Guideline.
The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant argued they should be removed from the MIG due to a fibromyalgia diagnosis and chronic pain syndrome.
The Tribunal found the applicant failed to provide sufficient evidence that their injuries fell outside the MIG or that a pre-existing condition prevented recovery within the MIG.
As the disputed treatment plans proposed treatment outside the MIG framework, they were denied.
Income replacement benefits denied; applicant failed to prove substantial inability to perform essential employment tasks.
The applicant sought income replacement benefits (IRBs) following a motor vehicle accident, claiming a substantial inability to perform his pre-accident employment as a hazardous material worker due to exacerbated chronic back pain and psychological symptoms.
The respondent denied the IRBs after December 1, 2019.
The Licence Appeal Tribunal dismissed the application, preferring the evidence of the respondent's medical assessors over the applicant's family physician.
The Tribunal found no objective findings to support the subjective complaints and concluded the applicant did not suffer a substantial inability to perform the essential tasks of his employment.
Claims for a special award and interest were also dismissed.
Application for physiotherapy benefits dismissed as the treatment was not proven reasonable and necessary.
The applicant was injured in a motor vehicle accident and sought a medical benefit of $2,314.48 for a physiotherapy treatment plan.
The respondent denied the claim.
The Licence Appeal Tribunal found that the applicant failed to prove the treatment was reasonable and necessary, noting that her treating physicians had not recently recommended passive therapy and an insurer's examination concluded she had reached maximum therapeutic improvement.
The application was dismissed and no interest was awarded.
Application for accident benefits dismissed as injuries fell within the Minor Injury Guideline funding limit.
The applicant was injured in a rear-end motor vehicle accident and sought statutory accident benefits.
The respondent determined the injuries fell within the Minor Injury Guideline (MIG) and refused to fund a $2,594.00 chiropractic treatment plan.
The applicant argued that pre-existing chronic back pain and ongoing pain precluded recovery within the MIG.
The Tribunal found insufficient evidence that the pre-existing condition or chronic pain warranted removal from the MIG.
As the applicant had already reached the $3,500 funding limit under section 18 of the Schedule, the disputed treatment plan and claim for interest were dismissed.
Medical benefits for chronic pain granted; special award denied as insurer's reliance on assessments was reasonable.
The applicant sought medical benefits for chronic pain treatment following a motor vehicle accident, which the respondent insurer denied based on its own medical examinations.
The Tribunal preferred the evidence of the applicant's chronic pain specialist over the insurer's examiners, finding that the applicant suffered from ongoing physical and psychological pain.
The Tribunal ordered the respondent to pay the disputed medical benefit and interest, but declined to order a special award, finding the insurer's denial was not unreasonable.
Applicant's injuries fell within the Minor Injury Guideline; claims for additional medical benefits dismissed.
The applicant was injured in a motor vehicle accident and sought medical and rehabilitation benefits under the Statutory Accident Benefits Schedule.
The respondent denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant's physical injuries, including cervical and thoracic strains, were predominantly minor.
The Tribunal also found that the applicant failed to provide compelling evidence of a psychological injury or a pre-existing medical condition that would remove her from the MIG.
Consequently, the applicant is subject to the $3,500 MIG limit, and the claims for additional treatment plans and examination costs were dismissed.