14 total
Application for accident benefits dismissed; applicant failed to prove injuries warranted removal from the Minor Injury Guideline.
The applicant sought statutory accident benefits following a motor vehicle accident, disputing the insurer's determination that his injuries fell within the Minor Injury Guideline (MIG).
The applicant argued for removal from the MIG based on a pre-existing degenerative disc disease and chronic pain.
The Licence Appeal Tribunal found that the applicant failed to provide compelling medical evidence that his pre-existing condition prevented maximal recovery within the MIG.
Furthermore, applying the AMA Guides, the Tribunal concluded the applicant did not meet the criteria for chronic pain with functional impairment, noting he continued to work and exercise.
The application was dismissed, and the disputed treatment plan was not considered as the applicant remained subject to the MIG limit.
Applicant's injuries found to fall within Minor Injury Guideline; claims for treatment plans and award dismissed.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied several treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant argued for removal from the MIG due to chronic pain and a psychological condition.
The Tribunal found that the applicant's chronic pain and psychological issues pre-dated the accident and were not substantially worsened by it.
The Tribunal preferred the respondent's physiatry assessment over the applicant's occupational therapy assessment, noting methodological flaws in the latter.
The Tribunal concluded the injuries were predominantly minor, dismissed the claims for the treatment plans, and denied the claim for an award under s. 10 of O. Reg. 664.
Reconsideration granted and decision cancelled where adjudicator failed to address key evidence of functional limitations.
The applicant requested a reconsideration of a Licence Appeal Tribunal decision that found she remained within the Minor Injury Guideline (MIG).
The applicant argued the Tribunal erred by failing to explicitly address key evidence of her functional limitations, specifically an in-home occupational therapy assessment report.
The Vice-Chair agreed, finding that the failure to address this central evidence regarding chronic pain and functional limitations constituted an error of fact or law that likely impacted the outcome.
The original decision was cancelled and the matter was remitted for a rehearing before a new adjudicator based on the existing written record.
The applicant sought statutory accident benefits following a motor vehicle accident, claiming her injuries warranted removal from the Minor Injury Guideline (MIG) due to chronic pain and a pre-existing psychological condition.
The Licence Appeal Tribunal found insufficient medical evidence to establish chronic pain with a functional limitation.
Furthermore, the Tribunal relied on a section 44 psychological assessment to conclude that the applicant's pre-existing psychological condition did not prevent her from achieving maximal recovery within the MIG limits.
The application was dismissed, and the applicant was held to the MIG.
Applicant permitted to proceed with accident benefits claim after establishing reasonable explanation for late OCF-1.
The applicant was involved in a motor vehicle accident and sought statutory accident benefits.
The respondent argued the applicant was barred from proceeding because she failed to submit her application for benefits (OCF-1) within 30 days of receiving the forms, as required by section 32(5) of the Schedule.
The Tribunal found that while the application was submitted late, the applicant had a reasonable explanation for the delay under section 34, citing her post-accident concussion symptoms, chronic pain, and significant stress related to a potential eviction.
The Tribunal concluded the hardship to the applicant outweighed any prejudice to the respondent, allowing the application to proceed.
Applicant permitted to proceed with accident benefits claim despite late application due to reasonable explanation.
The respondent insurer argued the applicant was barred from proceeding because she failed to submit her application for benefits (OCF-1) within the 30-day time limit prescribed by section 32(5) of the Schedule.
The Tribunal concluded the hardship to the applicant outweighed any prejudice to the respondent, allowing the claim to proceed.
The court granted summary judgment dismissing a personal injury claim as statute-barred by the 15-year ultimate limitation period.
The court granted summary judgment in favour of Makita Canada Inc., dismissing Mark Hennebury’s personal injury action as statute-barred by the 15-year ultimate limitation period under the Limitations Act, 2002.
The court found that the alleged negligence related to the manufacture and distribution of a power router occurred more than 15 years before the action was commenced, and that there was no continuing cause of action to toll the limitation period.
The court also held that the matter was suitable for summary judgment and did not require a trial to resolve credibility issues.
Accident benefits denied; applicant failed to prove shoulder injury was caused by the motor vehicle accident.
The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant contended that a right shoulder injury requiring surgery warranted removal from the MIG.
The Tribunal found that the applicant failed to prove the shoulder injury was caused by the accident, noting a two-year delay in reporting the pain and medical records suggesting a workplace injury.
As the applicant remained within the MIG and the limits were exhausted, the claims for treatment plans, attendant care, interest, and an award were dismissed.
Application for accident benefits dismissed as injuries fell within the Minor Injury Guideline limits.
The respondent denied the claims, arguing the injuries fell within the Minor Injury Guideline (MIG).
The applicant argued for removal from the MIG due to chronic pain and a pre-existing degenerative disc disease.
The Tribunal found the applicant did not meet the burden of proving chronic pain syndrome or that a pre-existing condition precluded recovery within the MIG.
As the MIG limits were exhausted, the disputed treatment plans were not payable.
The Tribunal also found that a procedurally defective denial of one treatment plan did not render it payable because the expenses were incurred before the plan was submitted.
The application was dismissed.
Application for accident benefits dismissed; applicant failed to prove chronic pain warranted removal from MIG.
The applicant sought accident benefits following a motor vehicle accident, arguing his injuries warranted removal from the Minor Injury Guideline (MIG) due to chronic pain with a functional impairment.
The Licence Appeal Tribunal found the applicant failed to prove on a balance of probabilities that his chronic pain was caused by the accident, noting clinical records attributed his back pain to other sources.
As the applicant remained subject to the MIG limit, his claim for a $2,195.00 physiotherapy treatment plan was dismissed, along with claims for a special award and interest.
Application for accident benefits dismissed; applicant failed to prove injuries warranted removal from Minor Injury Guideline.
The applicant applied to the Licence Appeal Tribunal, arguing for removal from the MIG due to a pre-existing injury, chronic pain, and psychological impairments.
The Tribunal found that the applicant failed to demonstrate that his accident-related impairments warranted removal from the MIG, as the medical evidence did not support a pre-existing condition precluding recovery or a diagnosis of chronic pain.
Applicant failed to prove chronic pain syndrome; remains subject to the Minor Injury Guideline.
The applicant sought statutory accident benefits following a motor vehicle accident but was denied by the respondent insurer on the basis that his injuries fell within the Minor Injury Guideline (MIG).
The applicant applied to the Licence Appeal Tribunal, arguing he should be removed from the MIG due to chronic pain.
The Tribunal found that the applicant failed to establish a diagnosis of chronic pain syndrome or continuous functional impairment arising from accident-related chronic pain.
The Tribunal also found the applicant did not meet the criteria for chronic pain under the AMA Guides.
Consequently, the applicant remains subject to the MIG and is not entitled to the disputed treatment plan for physiotherapy.
Accident benefits claims dismissed as applicant failed to prove injuries warranted removal from the Minor Injury Guideline.
The applicant contended he should be removed from the MIG due to a concussion, chronic pain, psychological impairments including PTSD, and a pre-existing medical condition.
The Tribunal found insufficient evidence to support a concussion, chronic pain under the AMA Guides, or accident-related psychological impairments.
As the applicant's injuries were predominantly minor and the MIG limits were exhausted, the claims for psychological and physiotherapy services were dismissed, along with claims for a special award and interest.
Occupational therapy assessment approved for psychological impairments; special award denied as insurer reasonably relied on assessors.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits, specifically $1,700 for an occupational therapy assessment.
The insurer denied the benefit based on insurer examination reports suggesting no residual physical impairment and no functional limitations from psychological issues.
The Licence Appeal Tribunal found the assessment reasonable and necessary to address the applicant's functional limitations arising from her accident-related psychological impairment, noting her ongoing struggles with focus, concentration, and work duties.
However, the Tribunal dismissed the applicant's claim for a special award under s. 10 of Regulation 664, finding that the insurer's reliance on its medical assessors was not excessive, imprudent, or stubborn.
The applicant was awarded the cost of the assessment plus interest.