6 total
Application for accident benefits dismissed; injuries fall within the Minor Injury Guideline.
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 Tribunal found that the applicant failed to establish chronic pain with functional impairment or a psychological impairment that would warrant removal from the MIG.
The Tribunal also dismissed the claim for income replacement benefits, finding insufficient medical evidence to prove a substantial inability to perform the essential tasks of employment.
The application was dismissed.
Application for statutory accident benefits dismissed as treatment plans and attendant care were not reasonable and necessary.
The applicant sought entitlement to statutory accident benefits following a motor vehicle accident, including multiple treatment plans for physiotherapy, chiropractic, and psychological services, as well as attendant care benefits.
The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove on a balance of probabilities that the disputed treatment plans and attendant care expenses were reasonable and necessary.
The Tribunal preferred the evidence of the respondent's independent examiners over the applicant's assessors and noted the applicant's failure to provide requested information to the insurer.
Claims for interest and an award under s. 10 of Reg. 664 were also dismissed.
Application for accident benefits dismissed; injuries fell within Minor Injury Guideline and income replacement denied.
The insurer denied benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Licence Appeal Tribunal found that the applicant failed to prove on a balance of probabilities that he suffered from accident-related chronic pain or psychological impairments warranting removal from the MIG, preferring the evidence of the insurer's assessors.
The Tribunal also dismissed the claim for an income replacement benefit, finding insufficient evidence of the applicant's pre-accident self-employment as a social worker or inability to perform his duties as an Uber driver.
Applicant's injuries found to be predominantly minor; removal from Minor Injury Guideline denied.
The applicant was injured in a motor vehicle accident and sought medical benefits for chiropractic, physiotherapy, and psychological assessments.
The insurer denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant failed to prove her injuries were not predominantly minor.
The medical evidence did not support a diagnosis of chronic pain or a psychological impairment that would warrant removal from the MIG.
As the injuries were within the MIG, the Tribunal did not need to determine the reasonableness and necessity of the treatment plans, and no interest was payable.
Application for accident benefits beyond the Minor Injury Guideline dismissed due to insufficient medical evidence.
The applicant was injured in a motor vehicle accident and sought medical benefits for physiotherapy beyond the $3,500 Minor Injury Guideline (MIG) limit.
The applicant argued that chronic neck pain and pre-existing degenerative disc disease warranted removal from the MIG.
The Tribunal found insufficient medical evidence to support a diagnosis of chronic pain causing functional impairment or to show that pre-existing conditions prevented maximal medical recovery within the MIG.
The application for the physiotherapy treatment plan, interest, and a bad faith award was dismissed.
Applicant designated catastrophically impaired due to marked psychological impairment in the domain of adaptation.
The applicant, a pedestrian struck by a vehicle, sought a determination that she sustained a catastrophic impairment due to psychological and emotional damage.
The Tribunal reviewed extensive medical and occupational therapy evidence, finding that the applicant's pre-accident active lifestyle had been replaced by severe avoidant behaviours, fatigue, and an inability to cope with stress.
Preferring the evidence of the applicant's psychiatric assessor over the respondent's, the Tribunal concluded the applicant suffered a marked impairment in the domain of adaptation.
The claims for interest and a special award were dismissed as there were no specific monetary benefits in dispute.