3 total
Applicant removed from Minor Injury Guideline due to chronic pain; chronic pain assessment approved.
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 with functional impairment, supported by ongoing treatments and specialist assessments, warranting removal from the MIG.
The Tribunal approved the treatment plan for a chronic pain assessment but denied the claims for an attendant care assessment and chiropractic services, finding them not reasonable and necessary.
Interest was awarded on the approved chronic pain assessment.
Application for accident benefits dismissed as injuries fell within the Minor Injury Guideline.
The respondent denied certain treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant contended that she suffered from accident-related psychological impairments and chronic pain, warranting removal from the MIG.
The Tribunal found that the applicant failed to prove on a balance of probabilities that she suffered from a psychological impairment or chronic pain with functional impairment that would remove her from the MIG.
As the disputed treatment plans were submitted on the basis that the injuries were outside the MIG, they were not payable.
The application was dismissed.
Application for income replacement benefits dismissed due to lack of contemporaneous medical evidence supporting disability.
The applicant sought Income Replacement Benefits (IRBs) following a motor vehicle accident, claiming a substantial inability to perform his pre-accident essential tasks as a security guard due to a knee injury.
The respondent insurer terminated the benefits based on an insurer's examination concluding the knee issues were not causally related to the accident.
The Licence Appeal Tribunal dismissed the application, finding the applicant failed to provide contemporaneous medical evidence demonstrating an inability to perform the essential tasks of prolonged sitting and walking during the disputed period, noting he had engaged in sedentary work and later took a physically demanding job.