2 total
Claim for adjustable bed and specialty bedding denied as not reasonable and necessary for recovery.
The applicant, who suffered a lower limb amputation in a motor vehicle accident, sought $8,000.49 for assistive devices including an adjustable bed, platform bed, and specialty bedding.
The respondent had partially approved the treatment plan for a memory foam mattress but denied the remaining items.
The Tribunal found that the applicant failed to prove the disputed items were reasonable and necessary.
Relying on the respondent's in-home occupational therapy assessment, the Tribunal concluded the applicant could safely transfer using his existing bedframe and that comfort alone did not satisfy the statutory criteria for funding.
Home modification claim partially approved for kitchen accessibility; extensive structural additions denied as unnecessary.
The applicant, who sustained a traumatic brain injury in a motor vehicle accident, sought $405,713.12 for extensive home modifications under the Statutory Accident Benefits Schedule.
The proposed modifications included levelling floors, widening doorways, installing a basement stairlift, and building a main-floor addition for a bedroom and laundry.
The Tribunal found that most of the requests were not reasonable and necessary, as the applicant failed to demonstrate their need or had reasonable alternatives available within the home.
However, the Tribunal approved $28,900.00 for the creation of a functional kitchen space to accommodate the applicant's mobility issues and use of a walker.
No co-appearing lawyers found.
No judges found.