2 total
Chiropractic treatment plan approved; insurer's examination given less weight due to inconsistency with diagnostic imaging.
The applicant was injured in a motor vehicle accident and sought $1,524.00 for a chiropractic treatment plan.
The respondent insurer denied the benefit, relying on an insurer's examination which concluded the applicant had reached maximum medical improvement.
The Tribunal found the treatment plan reasonable and necessary, placing less weight on the insurer's examination as it was inconsistent with diagnostic imaging and the longitudinal clinical record showing ongoing shoulder and chest impairments.
The applicant was awarded the cost of the treatment plan.
Application for accident benefits dismissed; pre-existing scoliosis did not warrant removal from Minor Injury Guideline.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits.
The insurer determined the injuries fell within the Minor Injury Guideline (MIG).
The applicant argued that his pre-existing mild scoliosis warranted removal from the MIG.
The Tribunal found insufficient medical evidence to establish that the pre-existing condition precluded his recovery within the MIG framework.
As the applicant had exhausted the $3,500 funding limit, the disputed treatment plan was denied and the application was dismissed.
