Nicole Walker

The applicant sought statutory accident benefits following a motor vehicle accident, claiming his physical and psychological injuries warranted removal from the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that the applicant's injuries were predominantly minor, noting that his self-reported symptoms were inconsistent and did not demonstrate functional impairment.

The Tribunal preferred the respondent's s. 44 assessors over the applicant's pre-screening report.

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

The applicant sought entitlement to a $9,024.34 treatment plan for a chronic pain program following a motor vehicle accident, along with interest and an award for unreasonable delay.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to meet her evidentiary burden to prove the treatment was reasonable and necessary.

The adjudicator noted the applicant's case was hampered by a lack of contemporaneous evidence and a failure to properly pinpoint evidence within the submitted medical reports as required by the case conference report and order.

Consequently, the claims for interest and an award were also dismissed.

The applicant sought $9,024.34 for a chronic pain treatment plan following a 2017 motor vehicle accident.

The respondent denied the benefits, arguing the applicant had recovered and returned to work full-time.

The Tribunal found the treatment plan was not reasonable or necessary, noting a three-year gap between the chronic pain assessment and the treatment plan, a lack of corroborating medical evidence, and the applicant's successful return to a physically demanding job.

The claims for an award under s. 10 of Reg. 664 and interest were also dismissed.

The applicant sought accident benefits following a motor vehicle accident, arguing her left sternoclavicular joint injury and chronic pain warranted removal from the Minor Injury Guideline (MIG).

The Tribunal found that while the accident caused the subluxation of the joint, the applicant failed to demonstrate that the injury caused functional impairment or met the criteria for chronic pain.

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

Consequently, the applicant's claims for a chronic pain assessment, interest, and an award for unreasonable delay were dismissed.

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

The Tribunal found that the applicant failed to prove her injuries warranted removal from the Minor Injury Guideline (MIG), as the medical evidence did not establish chronic pain with functional impairment or a psychological condition.

However, the Tribunal ordered the respondent to pay for three disputed treatment plans because the respondent failed to prove it delivered valid denial letters within the required 10 business days under s. 38(8) of the Schedule.

The applicant's claim for an award under s. 10 of Reg. 664 was dismissed.

The applicant sought statutory accident benefits after witnessing a fatal bus accident, claiming it caused a catastrophic impairment (schizophrenia).

The respondent denied the benefits, arguing the applicant's condition was pre-existing or prodromal.

The Tribunal found that while the accident may have triggered an acute psychotic episode, the applicant was likely prodromal for years prior and failed to prove he sustained a Class 4 marked or Class 5 extreme impairment in the required spheres of function.

The Tribunal also dismissed claims for attendant care, rehabilitation support worker services, and other expenses, as the applicant's non-catastrophic policy limits were exhausted and the expenses were either not incurred or not reasonable and necessary.

The applicant sought reconsideration of a decision finding his injuries fell within the Minor Injury Guideline (MIG) and denying his claims for chiropractic treatment.

The applicant argued there was new evidence (his psychiatrist's clinical notes) and that the adjudicator erred in law by failing to request these records.

The adjudicator dismissed the request, finding that the records were not new evidence as they had not yet been produced, there was no evidence they could not have been reasonably obtained earlier, and the applicant failed to show they would have affected the result.

The adjudicator also found no error of law, noting the applicant bears the onus to adduce evidence.

The applicant sought statutory accident benefits for physiotherapy and a psychological assessment following a May 2016 motor vehicle accident.

The Licence Appeal Tribunal dismissed the application, finding the applicant failed to prove the treatments were reasonable and necessary as a result of the subject accident.

The Tribunal noted significant gaps in the medical records and unrefuted evidence of subsequent intervening accidents, including another motor vehicle accident and a cycling accident, which likely caused the current injuries.

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

The respondent denied a treatment plan for a chronic pain assessment, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) limit of $3,500.

The Tribunal found that the applicant suffered from chronic pain, removing her from the MIG.

The Tribunal ordered the respondent to pay $2,000 for the chronic pain assessment and interest on overdue payments, but denied the applicant's claim for an award under Regulation 664 as there was no evidence of unreasonable delay.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits for chiropractic treatment.

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

The applicant argued that a pre-existing psychological condition and a psychological injury sustained in the accident removed him from the MIG.

The Tribunal found that the applicant's physical injuries were predominantly minor and that he failed to provide compelling evidence of a pre-existing condition that would prevent maximal recovery under the MIG.

The Tribunal also found no evidence of a psychological impairment beyond psychosocial sequelae.

The application was dismissed.

The applicant, a pedestrian struck by a vehicle, sought statutory accident benefits for medical and rehabilitation treatments.

The respondent denied the claims, arguing the injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit was exhausted.

The Tribunal found that the applicant's physical injuries were minor and that she failed to prove a pre-existing condition or a psychological impairment that would warrant removal from the MIG.

The Tribunal preferred the respondent's comprehensive psychological assessment over the applicant's pre-screen.

As the injuries fell within the MIG and the limit was exhausted, the claims for further treatment and interest were dismissed.

The applicant was injured in a motor vehicle accident and sought medical benefits for three chiropractic treatment plans under the Statutory Accident Benefits Schedule.

The respondent insurer denied the plans based on section 44 assessments.

The Licence Appeal Tribunal found the treatment plans reasonable and necessary, noting the applicant's pre-existing osteoarthritis and ongoing pain.

The Tribunal rejected the insurer's medical assessments because they failed to account for key medical evidence, including a diagnostic imaging report.

The applicant was awarded the disputed benefits and interest.