4 total
Physiotherapy treatment plan denied due to lack of contemporaneous medical evidence supporting its necessity.
The applicant sought $798.00 for a physiotherapy treatment plan following a motor vehicle accident.
The respondent denied the benefit.
The Tribunal found that the applicant failed to prove the treatment was reasonable and necessary, as the supporting medical recommendation was over a year old and lacked contemporaneous evidence.
The Tribunal also dismissed the applicant's request for costs, finding the respondent's erroneous limitation defence did not meet the threshold for bad faith.
Appeal dismissed; LAT properly restricted chiropractor from providing psychological diagnoses for catastrophic impairment assessment.
The appellant was injured in an ATV rollover and applied for a determination of catastrophic impairment under the Statutory Accident Benefits Schedule.
The Licence Appeal Tribunal (LAT) found she was not catastrophically impaired, giving little weight to the impairment ratings of her chiropractor, who had offered psychological diagnoses beyond his scope of practice.
On appeal, the Divisional Court found no error of law in the LAT's treatment of the chiropractor's evidence, affirming that while a chiropractor may compile impairment ratings under the AMA Guides, they cannot provide medical diagnoses outside their expertise.
The appeal was dismissed.
The court dismissed a motion to claw back life insurance proceeds already paid to a designated beneficiary, finding it an impermissible collateral attack on a prior order.
The plaintiffs brought a motion seeking various relief concerning the estate of the late Dean Joseph Costanza, including a suspensory order under the Succession Law Reform Act, a Mareva injunction, and an order to deposit life insurance proceeds into trust.
They argued that the $500,000 life insurance payout, designated to the minor defendant, should be deemed part of the deceased's net estate for dependant support purposes under s. 72(1)(f) of the Act.
The court dismissed these requests, finding that the life insurance proceeds, already paid out pursuant to a prior unappealed court order, were not subject to clawback under s. 72(1)(f) due to the application of s. 72(7) and because they were no longer "payable." The court further held that the plaintiffs' requests constituted an impermissible collateral attack on the prior order and an abuse of process.
The Mareva injunction was also denied as the plaintiffs failed to establish a strong prima facie case or a genuine risk of asset dissipation.
Catastrophic impairment claim dismissed; applicant ordered to repay $9,977.20 in overpaid income replacement benefits.
The applicant was injured in an all-terrain vehicle rollover and sought a determination of catastrophic impairment under Criteria 6, 7, and 8 of the Statutory Accident Benefits Schedule.
The Tribunal found that the applicant did not meet the 55% whole person impairment threshold under Criteria 6 or 7, preferring the respondent's medical assessments over the applicant's, noting that the applicant's chiropractor improperly assigned ratings outside his scope of practice and without conducting in-person assessments.
The Tribunal also found the applicant did not suffer marked impairments in the spheres of function under Criterion 8.
Additionally, the Tribunal ordered the applicant to repay $9,977.20 in overpaid income replacement benefits to the respondent, plus interest.