Linda To

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

The respondent raised preliminary issues, arguing the application should be statute-barred under s. 55 of the Schedule because the applicant failed to attend two scheduled psychological insurer's examinations.

The Tribunal found that the requested examinations were reasonably necessary and properly scheduled, but declined to bar the application.

Instead, the Tribunal exercised its discretion to stay the proceedings for 120 days to allow the applicant to attend the examination.

A secondary issue regarding late production of evidence was resolved by admitting the evidence but assigning it less weight.

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

The respondent denied funding for physical therapies and assessments, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant's diagnoses of chronic pain syndrome and adjustment disorder, supported by expert assessments, warranted removal from the MIG.

The Tribunal rejected the respondent's argument that the expert assessments should be given less weight merely because the applicant had not complained of these issues to his treating practitioners.

The applicant was awarded all disputed treatment plans and interest.

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

The respondent insurer determined the injuries fell within the Minor Injury Guideline (MIG) and refused to fund several treatment and assessment plans.

The applicant applied to the Licence Appeal Tribunal, arguing that rotator cuff tendinopathy, psychological injuries, and chronic pain removed her from the MIG.

The Tribunal found that the rotator cuff injury met the definition of a minor injury and that there was insufficient evidence of psychological injuries or chronic pain, preferring the insurer's examination reports over the applicant's orthopaedic assessment.

The Tribunal concluded the applicant sustained predominantly minor injuries, making the disputed treatment plans and interest not payable as they exceeded the $3,500 funding limit.