Julianne Brimfield

The applicant requested a reconsideration of a Licence Appeal Tribunal decision denying entitlement to disputed treatment plans under the Statutory Accident Benefits Schedule.

The applicant argued the Tribunal made errors of law and fact, including applying the wrong test and imposing an unduly high threshold, and sought to introduce new evidence.

The Tribunal dismissed the request, finding no errors of law or fact that would have altered the outcome, and concluding that the proposed new evidence could have reasonably been obtained prior to the original hearing.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming removal from the Minor Injury Guideline (MIG) due to psychological impairments.

The Licence Appeal Tribunal found the applicant's psychological evidence unpersuasive, noting a lack of corroboration in clinical records and preferring the respondent's psychological assessment which found no substantive psychological impairment.

The Tribunal concluded the applicant failed to prove his injuries fell outside the MIG, dismissing the claims for psychological treatment, assessment, and interest.

The applicant, a minor, sought statutory accident benefits following a motor vehicle accident.

The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant failed to prove on a balance of probabilities that he suffered from a pre-existing condition, a physical impairment (concussion), or a psychological impairment that would warrant removal from the MIG.

As the applicant remained subject to the MIG limit, the disputed treatment plans were not considered.

Claims for an award and interest were also dismissed.

The applicant applied to the Licence Appeal Tribunal for statutory accident benefits but died before the written hearing.

Counsel attempted to continue the application without an appointed estate trustee.

The Tribunal found that it lacks jurisdiction to appoint an estate trustee and that counsel had not established legal authority to continue the claim on behalf of the deceased.

The application was dismissed to prevent an abuse of process pursuant to section 23 of the Statutory Powers Procedure Act.

The applicant sought accident benefits for psychological injuries allegedly sustained as a result of her spouse's involvement in a motor vehicle accident four years prior.

The respondent denied the claim, arguing the applicant was not an 'insured person' under section 3(1) of the Statutory Accident Benefits Schedule and had failed to apply within the prescribed timelines.

The Tribunal found that the applicant failed to provide evidence linking her psychological impairments to the accident, as her medical records did not mention the accident and instead noted unrelated anxiety.

Consequently, the Tribunal concluded the applicant was not an 'insured person' and dismissed the claim, finding it unnecessary to address the limitation period issue.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent denied several treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG due to pre-existing knee and back conditions, as well as an accident-related psychological condition.

The Tribunal found insufficient medical evidence to establish that the pre-existing conditions precluded recovery within the MIG, noting a lack of contemporaneous accident-related complaints.

The Tribunal also preferred the respondent's psychological assessment over the applicant's, finding no clinically significant psychological impairment.

Consequently, the applicant's injuries were deemed predominantly minor, and the disputed treatment plans were not analyzed.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent denied several treatment plans and an IRB report, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found the applicant's injuries were predominantly minor, as the medical evidence only supported conditions like sprains, strains, and whiplash-associated disorders.

The applicant failed to provide compelling medical evidence of a concussion or psychological condition warranting removal from the MIG.

Consequently, the treatment plans were not payable.

The Tribunal also denied the cost of an IRB report, finding it was not reasonable and necessary.

The applicant sought accident benefits following a motor vehicle accident.

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 failed to prove on a balance of probabilities that she sustained physical or psychological injuries warranting removal from the MIG.

The Tribunal also found that the respondent's denial letters complied with the notice requirements under s. 38(8) of the Schedule, and therefore the treatment plans were not payable under s. 38(11).

The application was dismissed.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits.

The respondent denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant applied to the Licence Appeal Tribunal, arguing for removal from the MIG due to pre-existing conditions, physical injuries including a concussion, and psychological impairments.

The adjudicator found insufficient medical evidence to support the applicant's claims, noting that complaints of concussion and psychological symptoms arose more than a year after the accident and following a separate assault.

The application was dismissed, and the applicant was found to remain subject to the MIG limit.

The applicant, a minor, sought statutory accident benefits following a motor vehicle accident.

The respondent denied benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG based on a concussion and psychological impairments.

The Tribunal found that the applicant failed to prove on a balance of probabilities that she sustained injuries warranting removal from the MIG, noting that the concussion and psychological diagnoses were made by a chiropractor outside his scope of practice, and medical records did not corroborate accident-related psychological impairments.

The application was dismissed.

The applicant, a minor, sought statutory accident benefits following a motor vehicle accident.

The respondent denied a treatment plan for chiropractic services on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG due to psychological impairment and alleged the respondent's denial notice was non-compliant with s. 38(8) of the Schedule.

The Tribunal found insufficient evidence of psychological impairment to warrant removal from the MIG.

The Tribunal also held that the respondent's denial notice was compliant and, relying on Zheng, noted that an improper denial does not permanently remove an insured from the MIG.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, arguing that his psychological impairments warranted removal from the Minor Injury Guideline (MIG).

The adjudicator found that the applicant failed to meet his burden of proof, noting that the family doctor's clinical notes were largely illegible and did not reference psychological complaints.

The adjudicator also rejected the applicant's psychological assessment report because it was conducted virtually and the assessor relied on irrelevant medical records.

As the applicant remained within the MIG and the $3,500 limit was exhausted, the disputed treatment plans and claim for interest were dismissed.

The applicant sought entitlement to statutory accident benefits for an endocrinology CAT assessment and various other CAT assessments following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to establish on a balance of probabilities that the proposed assessments were reasonable and necessary.

The Tribunal noted that the applicant's diabetes and pancreatitis pre-dated the accident and lacked a causal connection to it.

Furthermore, the applicant failed to justify the need for multiple psychiatric and occupational therapy assessments beyond the statutory caps.

Claims for interest and an award for unreasonable delay were also dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit and several treatment plans.

The Licence Appeal Tribunal dismissed the claim for the non-earner benefit, finding the applicant failed to prove a complete inability to carry on a normal life, largely due to unreliable self-reporting and significant pre-existing conditions.

The Tribunal also dismissed claims for a neurological assessment and psychological services as not reasonable and necessary.

However, the Tribunal ordered the respondent to pay for a chronic pain assessment because the respondent's denial notices were confusing and failed to comply with section 38(8) of the Schedule.

The applicant requested reconsideration of a Tribunal decision denying her income replacement benefits beyond April 23, 2024.

She argued the Tribunal erred in law by failing to consider contextual factors in the post-104 week test, such as the part-time nature of the reasonably suited employment, and misapprehended expert neurological evidence regarding her migraines.

The Tribunal found that while it erred in law by not applying the holistic analysis mandated by recent appellate jurisprudence, this error would not have changed the outcome given the medical evidence of her significant improvement.

The request for reconsideration was dismissed.

The applicant was a passenger in a motor vehicle accident and did not apply for statutory accident benefits until nine months later.

The insurer argued the claim was barred under s. 32(1) of the Schedule for failing to provide notice within seven days.

Applying the recent Divisional Court decision in Hussein v. Intact, the Tribunal found that the driver's report of the accident on the day it occurred triggered the insurer's positive obligation to inquire about injuries and assist the applicant.

Because the insurer failed to fulfill this obligation, and the applicant provided a credible explanation for the delay, the Tribunal held the applicant was not barred from proceeding with her claim.

The applicant sought accident benefits following a motor vehicle accident, which the respondent denied on the basis that the injuries fell within the Minor Injury Guideline (MIG).

The applicant argued his injuries were severe and included chronic pain, a knee injury, and a fractured finger.

The Tribunal found that the knee and finger injuries were unrelated to the accident and that the applicant had recovered from his accident-related sprains and strains within four months.

As the applicant failed to prove his injuries warranted removal from the MIG, the proposed physiotherapy treatment plans outside the MIG limit were denied, along with claims for an award and interest.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent denied benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and raised a preliminary issue that the application should be barred due to the applicant's failure to attend insurer examinations.

The Tribunal found the notice of examination was non-compliant, so the application was not barred.

However, the Tribunal concluded the applicant failed to prove on a balance of probabilities that he suffered from a psychological impairment or chronic pain with functional impairment.

Consequently, the applicant's injuries were deemed predominantly minor, keeping him subject to the $3,500 MIG limit, and the application for additional treatment plans and an award was dismissed.

The respondent requested a reconsideration of a Tribunal decision that removed the applicant from the Minor Injury Guideline (MIG) due to psychological impairment and approved treatment plans.

The respondent argued the Tribunal breached procedural fairness and made errors of law and fact by ignoring evidence and misapplying case law.

The Adjudicator dismissed the request, finding no breach of procedural fairness or errors of law or fact, noting that the respondent was improperly attempting to re-litigate the case and re-weigh the evidence.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued that pre-existing conditions, including diabetes and a prior workplace injury, as well as a psychological impairment, warranted removal from the MIG.

The Tribunal found that the applicant failed to provide compelling medical evidence that his pre-existing conditions prevented maximal recovery within the MIG.

Furthermore, the Tribunal placed greater weight on the respondent's section 44 neuropsychological assessment, finding the applicant did not suffer a psychological impairment warranting removal from the MIG.

The application was dismissed.