Kristen Hamilton

The applicant was injured in a motor vehicle accident and sought payment for a chiropractic treatment plan under the Statutory Accident Benefits Schedule.

The respondent partially approved the plan but denied the remaining $399.52.

The Tribunal found that the applicant failed to prove the disputed amount was reasonable and necessary, noting a lack of evidence showing significant improvement from prior chiropractic treatment and the applicant's own report to an orthopaedic surgeon that the treatment was unsuccessful.

The application was dismissed and no interest was awarded.

The applicant requested a reconsideration of a Tribunal decision that denied her entitlement to three treatment plans for physiotherapy services and an award.

The applicant argued the adjudicator misapplied sections 49.1 and 64 of the Statutory Accident Benefits Schedule regarding unlicensed service providers and document submission waivers.

The Tribunal dismissed the request, finding that the applicant failed to raise section 49.1 at the initial hearing and was attempting to re-litigate arguments regarding section 64, thereby failing to establish an error of law or fact under Rule 18.2(b).

The applicant sought payment for three physiotherapy treatment plans following a motor vehicle accident.

The respondent denied the plans because the health care provider and facility were not registered with the Health Claims for Auto Insurance (HCAI) system and the plans were not submitted through the Central Processing Agency (CPA) as required by the HCAI Guideline and the Statutory Accident Benefits Schedule.

The Tribunal found that the HCAI Guideline applied and the respondent had not waived the submission requirements.

The application for benefits, an award, and interest was dismissed.

The applicant requested a reconsideration of a Tribunal decision that found her injuries fell within the Minor Injury Guideline (MIG) and denied her treatment plans.

The applicant argued the Tribunal misinterpreted the medical evidence of her expert and erred by allowing the insurer to rely on a MIG position without conducting a section 44 examination.

The Tribunal dismissed the request, finding that section 44 examinations are not mandatory and that the original decision correctly weighed the medical evidence, including a CT scan that contradicted the applicant's expert regarding a suspected spinal fracture.

The applicant was injured 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 she should be removed from the MIG due to pre-existing lower back and knee conditions.

The Tribunal found that the applicant failed to provide compelling medical evidence that her pre-existing conditions precluded her recovery within the MIG limits.

The Tribunal concluded the applicant's injuries were predominantly minor and subject to the $3,500 MIG limit.

The application for disputed treatment plans, interest, and an award was dismissed.