3 total
Claim for chiropractic benefits dismissed as applicant had reached maximum medical improvement.
The applicant sought entitlement to a medical benefit of $1,395.72 for chiropractic services following a motor vehicle accident, as well as an award for unreasonably delayed payments and interest.
The adjudicator found that the applicant had reached maximum medical improvement, relying on an insurer's examination and the applicant's own family physician's records, which recommended self-directed exercise rather than chiropractic treatment.
The adjudicator concluded the applicant failed to prove the treatment plan was reasonable and necessary.
Consequently, the claims for an award and interest were also dismissed.
Reconsideration request dismissed as an improper attempt to reargue the merits of the denied treatment plan.
The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied a $2,298 physiotherapy treatment plan.
The applicant argued that the adjudicator made an error of fact and sought to introduce new medical evidence.
The Tribunal dismissed the request, finding that the applicant was improperly attempting to reargue the merits of the case and that the new evidence would not have affected the original outcome.
The respondent's request for costs was also dismissed, as the reconsideration request was not found to be frivolous, vexatious, or in bad faith.
Insurer's request for reconsideration denied; no error in relying on subjective complaints for treatment plans.
The respondent insurer requested a reconsideration of a decision granting the applicant entitlement to two treatment plans for chiropractic, massage, and physiotherapy.
The insurer argued the adjudicator erred in law by relying on subjective complaints and psychological evidence rather than objective physical evidence.
The adjudicator dismissed the reconsideration, finding no error in law in considering the totality of the evidence, including consistent subjective reporting, to determine if the treatment was reasonable and necessary.
The applicant's request for costs was also denied.