OLAT 2025

The applicant sought $3,638.00 for a chiropractic treatment plan following a motor vehicle accident.

The respondent insurer denied the plan, relying on an insurer's examination by an orthopedic surgeon who concluded the applicant sustained only minor soft tissue injuries.

The Tribunal found the applicant failed to prove the treatment was reasonable and necessary, noting a lack of objective medical evidence, a significant pre-existing workplace injury, and the persuasiveness of the insurer's examination.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to chiropractic services and a psychological assessment outside the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG based on a pre-existing condition, psychological impairment, and chronic pain.

The Tribunal found insufficient evidence to support a pre-existing condition or accident-related psychological impairment, preferring the respondent's section 44 psychological assessment over the applicant's uncorroborated self-reports.

The Tribunal also concluded the applicant's pain did not constitute a severe, debilitating condition accompanied by functional impairment.

Consequently, the applicant remained subject to the MIG limits and was not entitled to the disputed treatment plans, an award for unreasonable delay, or interest.

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

The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued that pre-existing conditions, including cervical radiculopathy and carpal tunnel syndrome, prevented her recovery within the MIG framework.

The Tribunal found that while the applicant had documented pre-existing conditions, there was no medical evidence demonstrating that these conditions precluded her recovery within the MIG.

Consequently, the applicant's impairments were deemed predominantly minor, and her claims for a physiotherapy treatment plan, a psychological assessment, and interest were dismissed.

The applicant sought a determination that she sustained a catastrophic impairment under Criterion 8 (mental and behavioural disorders) following a 2018 motor vehicle accident.

The respondent insurer denied the claim, arguing her impairments were largely due to a pre-existing 2011 slip and fall injury.

The Tribunal applied the 'but for' test and found the accident was a necessary cause of her current impairments.

Preferring the applicant's expert evidence, the Tribunal concluded the applicant suffered marked (Class 4) impairments in three domains: social functioning, concentration, persistence and pace, and adaptation.

The applicant was deemed catastrophically impaired.

The applicant sought statutory accident benefits for concussion-based treatment plans (vestibular and vision therapy) following a motor vehicle accident.

The Licence Appeal Tribunal found that the applicant failed to demonstrate the treatments were reasonable and necessary.

The Tribunal preferred the insurer's neurological assessment over the applicant's, noting the applicant's assessor relied heavily on self-reporting and provided inconsistent conclusions.

The application was dismissed, and no interest was payable.

The applicant sought a non-earner benefit following a motor vehicle accident.

The applicant argued that the insurer failed to provide a compliant notice under section 36(4) of the Schedule, and therefore the benefit was payable under section 36(6).

The Tribunal found that the insurer's denial letter was issued under section 36(7) following an insurer's examination, and the Schedule provides no remedy for non-compliance with section 36(7).

The Tribunal further found that the applicant failed to meet the substantive test for a non-earner benefit, as no evidence was provided to compare pre- and post-accident activities.

The application was dismissed, and the respondent's request for costs was denied.

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

The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant applied to the Licence Appeal Tribunal, claiming chronic pain and psychological impairments warranted removal from the MIG.

The Tribunal found the applicant failed to meet his burden of proof, noting a lack of medical evidence supporting chronic pain with functional impairment or a psychological condition.

As the applicant remained within the MIG, the disputed psychological assessment was not payable.

The application was dismissed.

The applicant sought payment for a $1,463.52 physiotherapy treatment plan following a motor vehicle accident.

The respondent insurer denied the plan based on insurer examinations indicating the applicant's soft tissue injuries had substantially resolved.

The Tribunal found that the applicant failed to prove the treatment was reasonable and necessary, as there was no current medical evidence supporting the need for ongoing facility-based therapy.

Claims for an award for unreasonable delay and interest were also dismissed.

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

The respondent denied the treatment plans for chiropractic services and a psychological assessment on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant failed to establish on a balance of probabilities that he suffered an accident-related psychological impairment or chronic pain with functional impairment warranting removal from the MIG.

The application was dismissed, and the claims for treatment plans, interest, and a section 10 award were denied.

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

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

The Licence Appeal Tribunal found that the applicant suffered from a chronic pain condition with functional impairment, warranting removal from the MIG.

The Tribunal further held that the disputed treatment plans for chiropractic services were reasonable and necessary to alleviate the applicant's ongoing pain.

The applicant was awarded the treatment plans plus interest on the overdue payments.

The applicant, who sustained a catastrophic impairment in a 2015 motor vehicle accident, sought entitlement to tutoring support for her daughter, attendant care benefits, and home modifications.

The Tribunal dismissed the claim for tutoring support, finding no evidence that the daughter required a tutor.

While the Tribunal found the applicant's attendant care needs were $3,155.86 per month based on her psychological and cognitive impairments, it denied payment because the expenses had not been incurred.

The claim for home modifications was dismissed as the applicant failed to connect the proposed modifications to her accident-related impairments.

The application was dismissed in its entirety.

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

The insurer denied benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and she did not qualify for a non-earner benefit.

The Licence Appeal Tribunal found the applicant failed to prove her pre-existing psychological condition prevented maximal recovery within the MIG.

The Tribunal also dismissed the claim for a non-earner benefit, finding the medical evidence demonstrated the applicant continued to engage in her pre-accident activities and did not suffer a complete inability to carry on a normal life.

The application was dismissed.

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

The respondent denied several treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found the applicant's pre-existing lower back pain and sciatica prevented her from achieving maximal recovery within the MIG, warranting removal.

The Tribunal granted entitlement to physiotherapy treatment plans, a chronic pain assessment, and a neurological assessment, finding them reasonable and necessary.

However, claims for chronic pain treatment, psychological services, and certain medical devices were dismissed for lack of supporting medical evidence.

Interest was awarded on the approved plans.

The applicant sought income replacement benefits following a motor vehicle accident, claiming substantial post-accident business losses from her self-employment as a pet store owner.

The respondent insurer denied the benefits and sought repayment of an alleged overpayment.

The Tribunal found that the applicant failed to meet her burden of proving the quantum of her income replacement benefits, as her claimed business losses were unsupported by documentary evidence and not proven to be caused by the accident.

The Tribunal also dismissed the respondent's claim for repayment, finding its accounting evidence lacked sufficient detail to establish the overpayment calculation.

Both claims were dismissed.

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

A three-day videoconference hearing was scheduled, but the applicant failed to attend.

The Tribunal confirmed that the applicant had received proper notice of the hearing.

Proceeding in the applicant's absence pursuant to section 7(1) of the Statutory Powers Procedure Act, the Tribunal found that the applicant failed to present any evidence or submissions to meet their onus of proving entitlement to the disputed benefits.

The application was dismissed.

The applicant sought catastrophic impairment benefits for psychological injuries sustained after her spouse was involved in a motor vehicle accident.

The respondent insurer initially denied the claim on the basis that the applicant was not directly involved in the accident, and later scheduled insurer's examinations (IEs) which the applicant refused to attend.

The respondent raised a preliminary issue seeking to bar the applicant from proceeding with her application due to her non-attendance.

The Tribunal found that the applicant had a reasonable explanation for not attending the IEs, as the respondent had predetermined she was legally ineligible for a catastrophic impairment designation.

The Tribunal permitted the applicant to proceed with her application subject to terms, including that the respondent reschedule the IEs and the parties consider adjourning the upcoming hearing.

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

The Licence Appeal Tribunal found insufficient medical evidence to corroborate the applicant's self-reported psychological impairments, noting she only visited a physician once post-accident.

The Tribunal concluded the applicant's injuries were predominantly minor and dismissed the claims for treatment plans outside the MIG limit.

The respondent's request for costs due to late submissions was also dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, disputing the insurer's determination that her injuries fell within the Minor Injury Guideline (MIG).

The applicant argued she suffered from chronic pain and a psychological disorder warranting removal from the MIG.

The Tribunal found the applicant's evidence of pain insufficient to establish functional impairment, preferring the respondent's physiatry assessment.

The Tribunal also accepted the respondent's psychological assessment, which found evidence of malingering and no diagnosable psychological injury.

As the injuries were predominantly minor and the MIG limits were exhausted, the claims for treatment plans, an award, interest, and costs were dismissed.

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

The Licence Appeal Tribunal found that the applicant's physical injuries were soft-tissue in nature and not corroborated by legible medical records to be outside the MIG.

Furthermore, the Tribunal assigned little weight to a psychological report that failed to consider non-accident-related stressors.

The Tribunal concluded the injuries were minor, and since the $3,500 MIG limit was exhausted, the disputed treatment plans and claim for a section 10 award were dismissed.

The applicant sought entitlement to statutory accident benefits following a motor vehicle accident, specifically claiming costs for psychiatric, orthopaedic, functional abilities, and psychological assessments, as well as a physiotherapy treatment plan.

The Tribunal dismissed the claims for the assessments, finding the applicant failed to demonstrate they were reasonable and necessary, noting she had already been diagnosed and was receiving treatments.

The Tribunal partially granted the physiotherapy treatment plan, approving it for pain reduction but excluding the cost of orthotic devices unrelated to the accident.

The claim for a special award under s. 10 of Reg. 664 was dismissed, as the insurer's conduct was not found to be unreasonable.

Interest was awarded on the overdue physiotherapy benefits.