4 total
Application for accident benefits dismissed; applicant failed to prove pre-existing condition warranted removal from MIG.
The applicant sought statutory accident benefits following a motor vehicle accident, claiming his injuries warranted removal from the Minor Injury Guideline (MIG) due to a pre-existing condition of Chronic Facet syndrome.
The adjudicator found the applicant failed to provide compelling medical evidence that the pre-existing condition would prevent maximal recovery within the MIG limits, preferring the evidence of the respondent's section 44 orthopaedic assessor over the applicant's chiropractor.
As the applicant remained subject to the MIG, the disputed treatment plans and claims for an award and interest were dismissed.
Application for accident benefits beyond the Minor Injury Guideline limit dismissed due to insufficient medical evidence.
The applicant was involved in a motor vehicle accident and sought accident benefits beyond the $3,500 Minor Injury Guideline (MIG) limit, claiming physical, psychological, and chronic pain impairments.
The Licence Appeal Tribunal found that the applicant failed to provide compelling medical evidence to warrant removal from the MIG.
The medical records were sparse, there was no formal psychological diagnosis, and the evidence did not support a finding of chronic pain with functional impairment.
The application was dismissed, and the disputed treatment plans and interest were denied.
Applicant's injuries found to be predominantly minor; treatment plan denied as MIG limits exhausted.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied a treatment plan for chiropractic services on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant failed to establish that his injuries warranted removal from the MIG, noting a lack of evidence of chronic pain or functional impairment.
As the MIG limits were exhausted, the treatment plan was not reasonable and necessary, and no interest was payable.
Applicant removed from Minor Injury Guideline due to psychological impairment; disputed treatment plans and interest awarded.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits.
The respondent insurer denied several treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The adjudicator found that the applicant's psychological symptoms, documented by her family physician shortly after the accident, warranted removal from the MIG.
The adjudicator approved the disputed psychological assessment and chiropractic treatment plans, finding them reasonable and necessary based on contemporaneous medical records.
The adjudicator also rejected the respondent's argument that one of the treatment plans was time-barred, noting that the limitation period was suspended by COVID-19 regulations.
The applicant was awarded the disputed benefits with interest.
