Natalie Shykula-Clarke

The applicant sought medical and rehabilitation benefits following a motor vehicle accident.

The adjudicator found that the applicant sustained predominantly minor injuries, as defined by the Schedule, and that there was no evidence of a pre-existing condition that would warrant extending the $3,500 limit.

The applicant's claims for various medical expenses and assistive devices were dismissed because she failed to submit the required treatment plans, claimed items not permitted under the Schedule, and failed to prove the expenses were reasonable and necessary.

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

The respondent insurer requested the applicant attend an insurer's examination (IE) to determine if the injuries fell outside the Minor Injury Guideline.

The applicant refused to attend, arguing the proposed assessor's professional designation did not match the practitioner who recommended the benefits.

The Tribunal held that an insured cannot dictate the identity of the IE assessor, provided they are a regulated health professional.

Because the applicant failed to attend a properly scheduled IE, section 55(1)(2) of the Schedule precluded the applicant from proceeding with the application.

The application was dismissed.

The appellant appealed a Licence Appeal Tribunal decision denying her income replacement benefits and a treatment plan.

She argued procedural fairness was breached because the hearing was held by telephone rather than in person, minor injury guidelines were added without notice, medical records were not fairly evaluated, and the rule in Browne v. Dunn was not followed.

The Divisional Court dismissed the appeal, finding no procedural unfairness in the telephone hearing, noting the appellant should have been aware of the MIG issue, and concluding the adjudicator reasonably evaluated the medical evidence.

The applicant sought statutory accident benefits following a motor vehicle accident, including income replacement benefits (IRBs), medical and rehabilitation benefits, and costs of examinations.

The Tribunal found the applicant was entitled to IRBs for a limited period until she returned to full-time work, but denied ongoing IRBs due to a lack of financial evidence.

The Tribunal denied payment for two chiropractic treatment plans and found the applicant was barred from litigating a chronic pain treatment program because she failed to attend required insurer's examinations.

However, the Tribunal approved two assessment plans for physiatry and chronic pain, finding them reasonable and necessary.

The applicant's requests for a special award and costs were dismissed.

The applicant sought reconsideration of a Licence Appeal Tribunal decision denying her claims for an income replacement benefit and medical benefits following a motor vehicle accident.

The applicant argued the Tribunal ignored medical evidence of pre-existing conditions that would take her outside the Minor Injury Guideline (MIG), improperly admitted surveillance evidence, and breached procedural fairness by denying an in-person hearing and a request to record the proceedings.

The Executive Chair dismissed the request for reconsideration, finding no error in the Tribunal's conclusion that there was no compelling evidence the pre-existing conditions prevented maximal recovery under the MIG, and no breach of procedural fairness.

The respondent insurer sought reconsideration of a Licence Appeal Tribunal decision that allowed the applicant's dispute resolution application to proceed despite her refusal to attend an in-person physiatry examination.

The insurer argued the examination was necessary to assess the applicant's physical impairment for a catastrophic impairment determination.

The Executive Chair denied the reconsideration request, upholding the finding that the in-person examination was not 'reasonably necessary' under s. 44(1) of the Statutory Accident Benefits Schedule.

The Tribunal found that the insurer already had sufficient information from previous in-person assessments by an occupational therapist to conduct a paper review for the whole person impairment rating.

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

The insurer terminated IRBs and denied further medical benefits on the basis that the applicant's injuries were predominantly minor and the $3,500 Minor Injury Guideline (MIG) limit had been exhausted.

The Tribunal found that the applicant did not suffer a substantial inability to perform the essential tasks of her pre-accident employment, relying on insurer examinations that showed her impairment was temporary and self-limited.

The Tribunal also held that the applicant failed to provide compelling medical evidence that her pre-existing conditions prevented her from achieving maximal recovery under the MIG.

The application was dismissed.

The applicant sought catastrophic impairment benefits following a motor vehicle accident.

The insurer requested five in-person insurer's examinations.

The applicant agreed to three but refused to attend an in-person physiatry examination and a cardiology examination, arguing they were excessive and unreasonable.

The insurer raised a preliminary issue that the applicant was precluded from proceeding with her application due to her non-compliance.

The Tribunal found that the in-person physiatry examination was not 'reasonably necessary' under section 44 of the Schedule, as it was overly intrusive and the insurer already had sufficient information from other assessments to conduct a paper review.

The applicant was permitted to proceed with her claim.

The Applicant was injured in a motor vehicle accident and sought statutory accident benefits.

The Insurer requested that the Applicant attend an independent medical examination (IME) with a psychiatrist to assess his treatment plan, Minor Injury Guideline applicability, and entitlement to non-earner benefits.

The Applicant failed to attend, arguing that the IME should be conducted by a psychologist, not a psychiatrist.

The Arbitrator found that there was a reasonable nexus between the Insurer's choice of a psychiatrist and the Applicant's injuries, given the overlap in specialties and the Applicant's pre- and post-accident psychiatric issues.

The Applicant is precluded from moving to an Arbitration Hearing until he complies with the scheduled IME.