Thomas McKinlay

The applicant sought entitlement to statutory accident benefits for vision therapy, occupational therapy, a therapeutic mattress, and a psychological assessment following a 2019 motor vehicle accident.

The Licence Appeal Tribunal dismissed all claims, finding that the applicant failed to prove the treatments and assessments were reasonable and necessary.

The Tribunal preferred the respondent's insurer examination reports, which concluded that the proposed vision therapy lacked validated efficacy and that the applicant had the functional ability to perform pre-accident activities without the proposed occupational therapy.

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

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 claimed psychological impairment warranted removal from the MIG.

The Tribunal found the applicant's evidence, consisting of a single psychological consultation report without psychometric testing, insufficient to establish a psychological impairment on a balance of probabilities.

The Tribunal concluded the applicant's injuries were predominantly minor and subject to the MIG limit.

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

The applicant sought statutory accident benefits for physiotherapy, psychological services, and occupational therapy assessments following a 2017 motor vehicle accident.

The respondent denied the treatment plans.

The adjudicator found that the applicant was precluded from claiming entitlement to two treatment plans submitted more than five years after the accident, pursuant to s. 20(1)(a) of the Schedule.

For the remaining plans, the adjudicator concluded the applicant failed to prove they were reasonable and necessary, noting conflicting evidence regarding the applicant's recovery from a prior 2015 accident and subsequent workplace injuries.

The adjudicator also found the respondent's denial notices were compliant with s. 38(8) of the Schedule.

The application was dismissed.

The applicant sought statutory accident benefits for chiropractic, psychological, and occupational therapy services following a 2006 motor vehicle accident.

The insurer denied the treatment plans and raised a preliminary issue that the plans were initially unsigned.

The Tribunal held that the insurer waived the signature requirement by failing to raise it in the initial denial letters.

On the merits, the Tribunal found the chiropractic and occupational therapy plans were reasonable and necessary to address the applicant's chronic pain, though mileage expenses for the occupational therapist were excluded.

The psychological treatment plans were denied due to insufficient evidence of ongoing psychological distress and the applicant's failure to attend previously approved sessions.