Alexander Woo

The applicant requested a reconsideration of a decision finding she suffered predominantly minor injuries and was not entitled to a physiotherapy treatment plan.

She argued the Tribunal violated procedural fairness and erred in law by requiring expert evidence for chronic pain and by concluding she could engage in daily activities despite her pain.

The adjudicator dismissed the request, finding no violation of procedural fairness or significant error of law or fact, as the applicant failed to provide objective evidence of chronic pain or functional impairment.

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

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

The adjudicator found that the applicant's injuries, primarily soft tissue sprains and strains, were predominantly minor and that there was insufficient evidence of chronic pain or functional impairment to warrant treatment beyond the MIG limit.

As the MIG limit was exhausted, the treatment plan was not payable, and claims for interest and a special award were dismissed.

The applicant was involved in a motor vehicle accident and sought a psychological assessment.

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

The Tribunal found that the applicant's physical injuries were predominantly minor and that there was insufficient evidence of a psychological impairment or chronic pain to warrant removal from the MIG.

The Tribunal also found that the proposed psychological assessment was not reasonable and necessary, as there was no objective evidence to suspect a psychological condition.

The application was dismissed.

The respondent was involved in a motor vehicle accident and received Income Replacement Benefits (IRBs) from the applicant insurer.

The respondent subsequently returned to full-time work but failed to notify the insurer and continued to claim and receive IRBs.

The respondent abandoned his initial application to the Tribunal, and the insurer proceeded with a claim for repayment of the overpaid IRBs.

The Tribunal found that the respondent's failure to report his return to work and his submission of an election form for IRBs while working constituted wilful misrepresentation.

The insurer was ordered to be repaid $4,431.14 pursuant to section 52 of the Statutory Accident Benefits Schedule.