Kateryna Vlada

The applicant sought various medical and rehabilitation benefits, out-of-pocket expenses, interest, and an award following a motor vehicle accident.

The Tribunal found the applicant partially entitled to the balance of three treatment plans for chiropractic and massage therapy services, plus interest, as the medical evidence supported ongoing physical complaints and the need for treatment.

However, the Tribunal denied the claims for psychological assessments and services, orthopaedic shoes, and out-of-pocket expenses due to a lack of supporting evidence and failure to establish statutory entitlement.

The claim for an award under s. 10 of Reg. 664 was also dismissed as the applicant made no submissions on the issue.

The applicant sought a determination that she sustained a catastrophic impairment as a result of a 2016 motor vehicle accident under Criteria 6, 7, and 8 of the Statutory Accident Benefits Schedule.

The Tribunal reviewed multidisciplinary assessments from both parties.

For Criterion 6 (physical), the Tribunal found a 36% whole person impairment, preferring the respondent's assessors on headaches and neurocognitive issues but the applicant's assessor on extremity impairments.

For Criterion 7 (combined physical and mental), the Tribunal added a 10% mental impairment rating based on the respondent's psychiatrist, resulting in a 42% combined impairment, falling short of the 55% threshold.

For Criterion 8 (mental/behavioural domains), the Tribunal found moderate impairments across all domains, rejecting the applicant's claims of marked or extreme impairments.

The application was dismissed.

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 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 entitlement to various medical and rehabilitation benefits, including psychological, chiropractic, massage, physiotherapy, and chronic pain assessments, as well as a catastrophic impairment determination assessment, following a 2014 motor vehicle accident.

The Licence Appeal Tribunal dismissed all claims, finding that the applicant failed to meet his burden of proving the treatment plans were reasonable and necessary.

Specifically, the Tribunal noted a lack of objective medical evidence linking the applicant's psychological and physical complaints to the subject accident rather than subsequent accidents, and highlighted significant gaps in the medical evidence.

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 insurer sought repayment of $8,841.98 in Income Replacement Benefits (IRBs) paid to the respondent following a motor vehicle accident.

The insurer had paid the maximum weekly IRB amount but later discovered, upon receiving the respondent's pay stubs, that she had returned to work and received short-term disability benefits, which reduced her IRB entitlement.

The Tribunal found that the insurer properly recalculated the benefits and provided valid notice of the overpayment.

The Tribunal ordered the respondent to repay the $8,841.98 overpayment, plus applicable interest.

The applicant sought income replacement benefits (IRBs) and medical and rehabilitation benefits following a motor vehicle accident.

The adjudicator found that the applicant failed to prove she suffered a substantial inability to perform the essential tasks of her pre-accident employment, noting inconsistencies in her reported employment and a lack of supportive medical evidence linking her physical and psychological impairments to the accident.

Furthermore, the applicant was found non-compliant with section 33 of the Schedule for failing to provide requested employment and income documentation.

The adjudicator also dismissed the claims for physiotherapy, psychological services, and a chronic pain program, finding the applicant did not establish that the treatments were reasonable and necessary or that she suffered from accident-related chronic pain.

The application was dismissed in its entirety.

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

The respondent denied funding for several psychological and physiotherapy treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found no compelling medical evidence that the applicant's physical soft tissue injuries or alleged psychological impairments warranted removal from the MIG.

The Tribunal preferred the respondent's psychological assessment over the applicant's, noting the applicant's assessor was not qualified to provide a psychological diagnosis.

The application was dismissed.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits from the respondent insurer.

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

The applicant applied to the Licence Appeal Tribunal, arguing his physical injuries fell outside the MIG and that he sustained an accident-related psychological impairment.

The Tribunal found that the medical evidence supported physical injuries consistent with the MIG, such as cervical strain and whiplash-associated disorder.

Furthermore, the Tribunal concluded the applicant did not sustain an accident-related psychological impairment, noting a lack of contemporaneous medical evidence corroborating his reported symptoms.

As the applicant remained within the MIG and the limit was nearly exhausted, the disputed treatment plans were denied.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming her injuries warranted removal from the Minor Injury Guideline (MIG) due to chronic pain.

The Licence Appeal Tribunal found that the applicant failed to demonstrate functional impairment or meet the criteria for chronic pain under the AMA Guides.

Consequently, the Tribunal held that the applicant's injuries were predominantly minor and subject to the $3,500 MIG limit.

The claims for a $2,200 chronic pain assessment and interest were dismissed.

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

The respondent insurer denied the benefits 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 paresthesia, chronic pain, and psychological impairments.

The adjudicator found insufficient medical evidence linking the paresthesia or imaging results to the accident.

Furthermore, the adjudicator concluded the applicant failed to establish chronic pain with functional impairment or a psychological impairment, noting inconsistencies between the applicant's self-reporting to different medical practitioners.

The application was dismissed, and the applicant was held to the MIG limits.

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

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

The Tribunal found the applicant suffered a psychological impairment, supported by a psychological assessment and family physician records, warranting removal from the MIG.

The applicant's claim for an income replacement benefit was dismissed for failing to prove a substantial inability to perform the essential tasks of her employment as a personal support worker.

However, the Tribunal approved all four disputed treatment and assessment plans for physiotherapy and psychological services, finding them reasonable and necessary, and awarded interest on overdue payments.

The applicant was riding an e-bike when she lost control and crashed, sustaining injuries including a fractured jaw.

She applied for statutory accident benefits, claiming a third-party vehicle encroached on her path, forcing her to swerve.

The respondent denied benefits, arguing there was no third-party vehicle involved and the incident did not meet the definition of an 'accident'.

The Tribunal found that the evidence, including 911 call transcripts and medical records, supported the applicant's version of events.

The Tribunal concluded that the use or operation of the third-party vehicle directly caused the impairments, satisfying both the purpose and causation tests under section 3(1) of the Schedule.

The applicant sought statutory accident benefits following a motor vehicle accident, including non-earner benefits (NEBs) and several treatment plans for physiotherapy, orthotics, and a chronic pain assessment.

The Licence Appeal Tribunal found that the applicant did not suffer a complete inability to carry on a normal life, as her impairments were not continuous and she was able to work part-time.

The Tribunal denied the physiotherapy and orthotics treatment plans due to a lack of compelling evidence of their reasonableness and necessity.

However, the Tribunal granted the $2,200 treatment plan for a chronic pain assessment, finding that the applicant's pain was worsened by the accident and warranted further investigation.

The applicant was injured in a motor vehicle accident and sought $2,486.00 for a chronic pain assessment under the Statutory Accident Benefits Schedule.

The respondent denied the treatment plan.

The Licence Appeal Tribunal found that the applicant failed to provide the treatment plan in evidence and did not establish its goals.

Furthermore, the medical evidence, including clinical notes and records, did not support a diagnosis of chronic pain or ongoing accident-related impairments.

The Tribunal dismissed the application, finding the assessment was not reasonable and necessary.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the insurer's denial of several treatment plans.

The Tribunal found the applicant was not entitled to an attendant care assessment because it was incurred before the treatment plan was submitted, contrary to section 38(2) of the Schedule.

The Tribunal partially approved a physiotherapy treatment plan for hourly services but denied per-procedure items that lacked evidence of compliance with the Professional Services Guideline.

The unapproved balance for chiropractic services was similarly denied.

However, the Tribunal granted entitlement to a chronic pain assessment, finding it reasonable and necessary given the applicant's persistent symptoms and functional limitations, and awarded interest on overdue payments.

The applicant sought a non-earner benefit following a motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove she suffered a complete inability to carry on a normal life.

The adjudicator noted that the applicant had returned to her pre-accident employment as a practical nurse, increased her hours to full-time, and failed to provide sufficient particulars regarding her pre-accident activities and how her pain practically prevented her from engaging in them.

As no benefits were payable, the claim for interest was also dismissed.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision which found her injuries were subject to the Minor Injury Guideline (MIG) limits.

The applicant argued the adjudicator erred in law and fact by misinterpreting the Schedule, misconstruing her injuries, and failing to assign the reconsideration to a different member.

The Tribunal dismissed the request, finding that having the same adjudicator hear the reconsideration does not violate procedural fairness.

Furthermore, the Tribunal held that the applicant was attempting to re-litigate her case and failed to establish any error of law or fact regarding the MIG determination or her chronic pain claims.

The applicant sought entitlement to statutory accident benefits for chiropractic, massage, psychotherapy, and catastrophic determination assessments following a 2017 motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to meet her evidentiary burden to prove the treatment and assessment plans were reasonable and necessary.

The Tribunal preferred the respondent's more current section 44 assessment reports over the applicant's outdated section 25 reports and noted the lack of consistent recommendations from treating physicians.