Stephen Alexander Whibbs

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

The respondent denied the benefits, arguing the applicant's psychological symptoms were related to his father's death rather than the accident.

The Licence Appeal Tribunal found that the applicant failed to demonstrate an accident-related psychological impairment, noting inconsistencies in his evidence and a lack of supporting medical documentation.

The application was dismissed, and the applicant remained subject to the MIG.

The applicant's estate sought statutory accident benefits following a 2018 motor vehicle accident, including a catastrophic impairment designation and chiropractic treatment plans.

The Licence Appeal Tribunal found it lacked jurisdiction to adjudicate the catastrophic impairment claim and a $20,000 treatment plan because the required OCF-19 and OCF-18 forms were never submitted to the insurer.

The Tribunal also dismissed the claim for a $2,825 chiropractic treatment plan, finding the applicant failed to provide medical evidence proving the treatment was reasonable and necessary.

Claims for interest and a special award were consequently dismissed.

The appellant appealed a Licence Appeal Tribunal (LAT) decision dismissing her application for catastrophic impairment benefits because she failed to attend an insurer's psychiatric examination.

The appellant argued the LAT erred in law by barring her entire application and breached procedural fairness.

The Divisional Court dismissed the appeal, finding no error of law as the appellant's counsel had confirmed to the LAT that non-CAT benefits were exhausted, making the CAT designation a prerequisite.

The Court also found no breach of procedural fairness, as the appellant had ample opportunity to make submissions and attend rescheduled examinations.

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

The insurer determined the injuries fell within the Minor Injury Guideline (MIG) and denied a physiotherapy treatment plan and income replacement benefits (IRBs).

The Tribunal found the applicant's physical and psychological injuries were minor and did not warrant treatment outside the MIG, dismissing the claim for physiotherapy.

However, the Tribunal awarded IRBs for a closed period because the insurer failed to comply with the procedural requirements of section 36(4) of the Schedule when responding to the applicant's disability certificate, entitling the applicant to benefits until a clear and unequivocal denial was issued.

The respondent insurer requested a reconsideration of a Tribunal decision finding the applicant catastrophically impaired.

The insurer alleged a reasonable apprehension of bias because the hearing adjudicator had a background in autism advocacy, which was relevant to the causation analysis of the applicant's impairments.

The Tribunal dismissed the request, finding the insurer improperly waited until after an unfavourable decision to raise the bias allegation.

Furthermore, the adjudicator's subject matter expertise did not displace the strong presumption of impartiality.

The insurer's remaining arguments regarding factual errors were dismissed as mere disagreements with the Tribunal's weighing of evidence.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision regarding her entitlement to attendant care benefits.

She argued the Tribunal made errors of law by finding it lacked jurisdiction to determine the rate for attendant care, by applying the ratio method to calculate payments, and by breaching procedural fairness through inadequate reasons.

The adjudicator dismissed the request, finding no errors of law or breaches of procedural fairness, as the original decision correctly applied the statutory scheme and provided sufficient reasons for its findings.

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

The insurer denied a treatment plan for chiropractic services, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant suffered from an accident-related psychological impairment (PTSD) that warranted removal from the MIG.

The Tribunal also found the proposed chiropractic treatment plan to be reasonable and necessary, ordering the insurer to pay the benefit with interest.

The applicant's claim for an award for unreasonable delay was dismissed.

The respondent insurer sought reconsideration of a decision finding the applicant sustained a catastrophic impairment and was entitled to income replacement benefits.

The insurer argued the adjudicator made errors of fact regarding the applicant's activity levels and errors of law by failing to cite case law or address section 57 of the Schedule.

The Tribunal dismissed the request, finding the initial conclusions were supported by medical and surveillance evidence, and that the insurer had failed to provide the requisite notice under section 57(4) to terminate benefits for non-compliance with treatment.

The applicant, who had pre-existing autism, was involved in a motor vehicle accident while riding her bike.

She sought a determination of catastrophic impairment and various statutory accident benefits.

The respondent denied the benefits, arguing her impairments were solely related to her pre-existing autism.

The Tribunal found that the accident was a necessary cause of her worsened psychological condition, leading to an extreme impairment in adaptation.

The applicant was deemed catastrophically impaired and awarded ongoing attendant care benefits and partial occupational therapy costs, but denied past attendant care benefits and other treatment plans.

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

The respondent denied benefits and raised a preliminary issue that the applicant failed to submit a completed application for benefits within 30 days of receiving the forms, as required by s. 32(5) of the Schedule.

The applicant argued she had a reasonable explanation for the delay due to mental health issues, addictions, and a broken foot.

The Tribunal found that while the explanation was credible, it was not reasonable, as medical records showed the applicant was capable of completing day-to-day tasks and obtaining assistance during the delay period.

The application was dismissed as barred from proceeding.

The applicant sought attendant care benefits, an award, and interest following a motor vehicle accident.

The Tribunal found the applicant entitled to $942.19 per month in attendant care benefits based on the occupational therapist's assessment of her needs for exercise supervision, bathing, and equipment maintenance.

The Tribunal dismissed the claims for incurred attendant care shortfalls, interest, and a section 10 award, finding the insurer's reliance on the ratio method and its own assessments was reasonable.

The respondent insurer brought a motion to bar the applicant from proceeding with her application for statutory accident benefits under s. 55(1)2 of the Schedule.

The applicant had attended an initial psychiatric insurer's examination but left before it was completed, citing discomfort with the assessor.

The applicant subsequently refused to attend rescheduled examinations with different assessors, arguing they were too intrusive.

The Tribunal found that the insurer was entitled to a complete examination and that the applicant failed to provide a reasonable explanation for her non-attendance.

The motion was granted and the application was barred from proceeding.

The Applicant sought a determination that he sustained a catastrophic impairment and was entitled to ongoing income replacement benefits following a 2017 motor vehicle accident.

The Respondent brought a preliminary motion to strike the Applicant's catastrophic impairment report, arguing it was not conducted by a physician as required by section 45(2)1 of the Schedule.

The Tribunal dismissed the motion, finding the report was directed by a physician and compliant with the Schedule.

On the merits, the Tribunal preferred the Applicant's expert evidence, concluding he suffered a marked impairment in all four areas of functioning due to somatic symptom disorder and major depressive disorder.

The Tribunal found the Applicant catastrophically impaired and completely unable to engage in suitable employment, granting entitlement to income replacement benefits and interest.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that barred her claims for income replacement benefits and a psychological assessment due to limitation periods.

The applicant argued the Tribunal breached procedural fairness by allowing the respondent to raise a limitation defence at the hearing and erred in law by not extending the time under s. 7 of the LAT Act.

The adjudicator dismissed the request, finding the applicant had a full opportunity to respond to the limitation defence and failed to request or provide grounds for a time extension.

The applicant was injured in a motor vehicle accident and sought removal from the Minor Injury Guideline (MIG) due to chronic pain and psychological impairments, as well as entitlement to income replacement benefits (IRBs) and various treatment plans.

The Tribunal found that the applicant's injuries were predominantly minor and fell within the MIG, noting inconsistencies in her medical records and self-reports.

The Tribunal preferred the evidence of the respondent's assessors over the applicant's experts.

As the MIG limits were exhausted, the treatment plans were denied.

The Tribunal also dismissed the claim for IRBs, finding insufficient evidence of a substantial inability to perform the essential tasks of her employment, and denied claims for interest and an award.

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 that her physical and psychological impairments warranted removal from the MIG, relying on a psychological assessment and clinical notes.

The Tribunal found that the physical injuries were minor and that the psychological symptoms did not rise to the level of an impairment precluding treatment within the MIG.

As the $3,500 MIG limit was exhausted, the disputed treatment plans were not payable, and claims for interest and an award were dismissed.

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

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

The applicant argued for removal from the MIG based on chronic pain and psychological impairment.

The Tribunal found the applicant failed to meet the burden of proof for chronic pain under the AMA Guides criteria and did not provide sufficient evidence of a psychological impairment.

The Tribunal concluded the injuries were predominantly minor and subject to the $3,500 MIG limit.

The disputed treatment plans were deemed reasonable and necessary up to the remaining MIG limit pursuant to s. 40(8) of the Schedule.

The application was otherwise dismissed.

The applicant sought a catastrophic impairment designation and attendant care benefits following a motor vehicle accident.

The Tribunal evaluated the competing multidisciplinary assessments to determine if the applicant met the 55% whole person impairment threshold under Criterion 7.

The Tribunal rejected several of the applicant's proposed impairment ratings, including those for the lumbar spine, headaches, mental status, and medication, finding them inconsistent with the AMA Guides and medical evidence.

The Tribunal concluded the applicant's combined whole person impairment was 45%, falling short of the catastrophic impairment threshold.

The application for benefits, interest, and costs was dismissed.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied her claims for various statutory accident benefits, including attendant care, housekeeping, and medical treatments.

The applicant argued that the adjudicator committed a material breach of procedural fairness, demonstrated institutional bias, and made several errors of law and fact.

The Tribunal dismissed the request, finding no reasonable apprehension of bias or breach of procedural fairness.

The Tribunal also concluded that the adjudicator made no errors of law or fact, noting that the applicant was improperly attempting to use the reconsideration process to reweigh the evidence.

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

The Licence Appeal Tribunal found the applicant failed to provide compelling medical evidence of chronic pain syndrome or psychological impairment caused by the accident.

The Tribunal preferred the respondent's section 44 assessments, which found the applicant's injuries were minor and did not result in functional impairment.

The application was dismissed, and the disputed treatment plans were denied.