Kimberley J. Tye

The applicant was injured in a motor vehicle accident and sought statutory accident benefits beyond the $3,500 Minor Injury Guideline (MIG) limit, claiming chronic pain and psychological impairments.

The Tribunal found insufficient evidence of a psychological condition or functional impairment caused by chronic pain to warrant removal from the MIG.

As the MIG limits were exhausted, the disputed treatment and assessment plans were not payable.

Claims for an award, interest, and costs were also dismissed.

The applicant was injured in a motor vehicle accident and sought income replacement benefits (IRBs).

The parties agreed the applicant was entitled to IRBs but disputed the quantum.

The self-represented applicant relied on an accounting report that calculated pre-accident income based on the 52 weeks prior to the accident, while the respondent relied on a report calculating income based on the last completed taxation year pursuant to s. 4(3) of the Schedule.

The Tribunal preferred the respondent's accounting report as it complied with the Schedule and relied on documentary evidence.

The Tribunal ordered IRBs payable in accordance with the respondent's calculations, plus interest on overdue payments.

The applicant sought a rehabilitation benefit of $4,534.35 for chiropractic services following a motor vehicle accident.

The respondent denied the claim on the basis that the treatment was not reasonable and necessary.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove the treatment was reasonable and necessary given her extensive pre-existing back issues, lack of documented accident-related complaints for a two-year period, and insufficient medical evidence linking the proposed treatment to the accident.

The applicant's claim for costs was also dismissed.

The respondent insurer brought a preliminary issue motion arguing that the Licence Appeal Tribunal lacks jurisdiction to determine whether an applicant is catastrophically impaired when there are no associated substantive benefits in dispute.

The adjudicator dismissed the motion, finding that the Insurance Act and the Statutory Accident Benefits Schedule do not require a claim for a specific substantive benefit to accompany an application for a catastrophic impairment determination.

The Tribunal has jurisdiction to determine catastrophic impairment on a stand-alone basis.