Loreto Scarola

The applicant requested a reconsideration of a previous Tribunal decision which found he was not removed from the Minor Injury Guideline (MIG) and was not entitled to the disputed treatment plans or non-earner benefits.

The applicant argued the Tribunal made errors of law or fact under Rule 18.2(b).

The adjudicator acknowledged a factual error regarding the applicant's pre-accident complaints to his family physician but concluded this error would not have changed the outcome, as there was ample evidence that the pre-existing conditions had resolved prior to the accident.

The request for reconsideration was dismissed.

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

The respondent denied the plans based on insurer's examinations.

The Licence Appeal Tribunal found the first chiropractic treatment plan reasonable and necessary, noting the applicant's ongoing pain and the physical impairments documented even in the respondent's own medical examination.

However, the Tribunal dismissed the claims for the second chiropractic plan and the psychological plan, finding insufficient evidence of ongoing physical impairment and concluding the applicant had already reached her psychological treatment goals.

The applicant was awarded the cost of the first chiropractic plan plus interest.

The applicant was injured in a motor vehicle accident and sought payment for psychological and physiotherapy assessments and treatments under the Statutory Accident Benefits Schedule.

The insurer denied portions of the claims based on independent medical examinations suggesting the costs were excessive or the treatments unnecessary.

The Licence Appeal Tribunal found the applicant's proposed treatment plans and assessments were reasonable and necessary, rejecting the insurer's independent examiners' conclusions as incomplete or unpersuasive.

The Tribunal ordered the insurer to pay the disputed amounts with interest, but denied the applicant's request for a special award.

The applicant was injured in a motor vehicle accident and sought payment for an orthopaedic assessment.

The respondent insurer denied the treatment plan, relying on an insurer's examination which concluded the assessment was not reasonable and necessary because the applicant was already being treated by an orthopaedic surgeon.

The Tribunal found the applicant's reports of pain were consistent and credible, and that the treating surgeon was only addressing her knee issues, not her whole-body pain.

The Tribunal concluded the orthopaedic assessment was reasonable and necessary to identify the source of her impairments and awarded the cost of $2,260.00 plus interest.

The applicant was injured in a motor vehicle accident and sought medical and rehabilitation benefits for psychological treatment and a chronic pain program.

The insurer denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline.

The Tribunal found that the applicant suffered from chronic pain and was entitled to partial payment for both treatment plans.

The rehabilitative components and psychological services were deemed reasonable and necessary, while transportation costs, social work, education elements, and additional progress reports were denied.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that found his injuries fell within the Minor Injury Guideline (MIG) and limited the cost of a psychological assessment to the remainder of the MIG limit.

The applicant argued the Tribunal erred in fact by preferring one psychological report over another and erred in law by approving the assessment without removing him from the MIG.

The Vice-Chair denied the request, finding no significant errors of fact or law, as the Tribunal correctly assessed the medical evidence and logically concluded that approving an assessment does not automatically remove an applicant from the MIG.

The applicant sought a medical and rehabilitation benefit of $12,001.80 for a chronic pain treatment program following a motor vehicle accident.

The insurer denied the claim.

The Tribunal found that the applicant did not meet the AMA criteria for chronic pain, noting that he had returned to full-time work, completed a university degree, and maintained social and self-care activities.

The Tribunal concluded the treatment was not reasonable and necessary, dismissing the appeal and the claims for interest and a special award.

Following a successful arbitration regarding statutory accident benefits, the insurer sought its expenses.

The arbitrator found the insurer's bill of costs to be excessive, noting that the arbitration was a straightforward case that took unnecessarily long.

The arbitrator reduced the claimed fees and disbursements, citing a lack of specificity in the bill of costs and excessive time spent by multiple individuals.

The applicant was ordered to pay the insurer $9,179.95 for the expenses of the arbitration.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits beyond the $3,500 limit prescribed by the Minor Injury Guideline (MIG).

The applicant claimed that chronic pain and psychological conditions, including adjustment disorder and post-traumatic stress, took his injuries outside the MIG.

The arbitrator found the applicant to be an unreliable historian who exaggerated his pain and functional limitations.

Relying on medical evidence that the applicant's psychological issues were clinically insignificant and his physical injuries were predominantly soft tissue strains, the arbitrator concluded the injuries fell within the MIG.

All claims for additional medical benefits, assessments, and a special award were dismissed.

The applicant was injured in a motor vehicle accident and applied for statutory accident benefits from State Farm.

A priority dispute between insurers was resolved, with Western Assurance assuming carriage of the claim.

State Farm brought a motion on consent to add Western Assurance as a party and remove itself from the arbitration.

The arbitrator granted the motion, finding jurisdiction under the Statutory Powers Procedure Act and the Dispute Resolution Practice Code to add and remove parties, and concluding that the proposed order was the most just, quickest, and least expensive manner of proceeding.