Arbitrator awards ongoing acupuncture and physiotherapy for chronic pain but denies experimental topical Ketamine cream.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits for ongoing acupuncture, physiotherapy, prescription medications, and transportation expenses.
The insurer denied the claims based on independent medical examinations suggesting the applicant had plateaued and that certain medications were experimental.
The arbitrator found that the acupuncture and physiotherapy treatments were reasonable and necessary for pain management and maintaining the applicant's functionality, despite her having reached a plateau.
The arbitrator also approved the claim for Tylenol #4 and transportation expenses.
However, the claims for topical Ketamine/DMSO and Flexeril were denied as experimental and inappropriate for long-term use.
The applicant's request for a special award due to the insurer's administrative errors was dismissed, as the errors did not cause an unreasonable delay in the payment of benefits.
L.E. v. Allstate Insurance Company of Canada, 2009 ONFSCDRS 145
