3 total
Applicant removed from Minor Injury Guideline due to chronic pain but denied physiotherapy treatment plan.
The applicant sought statutory accident benefits following a motor vehicle accident.
The insurer denied a treatment plan for physiotherapy and chiropractic services, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant's chronic musculoskeletal pain and resulting functional impairment warranted removal from the MIG.
However, the Tribunal dismissed the claim for the $2,675.00 treatment plan, finding the applicant failed to prove it was reasonable and necessary, particularly given medical evidence that facility-based treatment had provided no sustained benefit over four years.
Accident benefits claim dismissed; applicant failed to prove pre-existing condition removing her from Minor Injury Guideline.
The applicant sought statutory accident benefits following a rear-end motor vehicle collision.
The respondent denied a chiropractic treatment plan on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 funding limit had been reached.
The applicant argued that pre-existing disc bulges and chronic back pain prevented maximal recovery within the MIG limits.
The Tribunal found that the applicant failed to provide compelling medical evidence of a pre-existing condition that would remove her from the MIG.
As the injuries were predominantly minor, the treatment plan was not payable, and claims for interest and a special award were dismissed.
Application for accident benefits dismissed as proposed assessments and assistive devices were not reasonable and necessary.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits for various assessments and assistive devices.
The Licence Appeal Tribunal found that the applicant failed to prove the proposed neurological assessment, functional abilities evaluation, in-home ergonomic assessment, and assistive devices were reasonable and necessary.
The applicant's primary injury was a fractured forearm, which had largely resolved, and there was insufficient medical evidence to support the need for the disputed items.
The application was dismissed.
