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Pihokker v. The Personal (20-011554)

  • March 15, 2022

The claimant was involved in an automobile accident, and sought certain benefits that were subsequently denied by the insurer. The claimant previously applied to the Tribunal, where Adjudicator Ferguson released his decision (“the 2019 Decision”) which found that the claimant’s injuries fell within the MIG. The claimant did not seek reconsideration or judicial review of the 2019 Decision. The claimant subsequently submitted another treatment plan for chiropractor services along with updated records from his treating orthopaedic surgeon, which the insurer denied. The claimant commenced this new application before the LAT. The insurer argued that the application was subject to res judicata, as the claimant had not provided fresh evidence to impeach the Tribunal’s 2019 Decision. Adjudicator Kepman agreed with the insurer, and held that the application was barred by res judicata. The 2019 Decision held that the claimant fell within the MIG, and Adjudicator Kepman found that the new records and treatment plans would not have removed the claimant’s injury from the MIG.

Full decision here

TGP Analysis

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  • FILED UNDER LAT Rules, Minor Injury Guideline
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