Chronic pain program treatment plan approved where functional impairment exceeded physical signs of injury.
The applicant, who was struck by an automobile while riding a bicycle, sought a medical and rehabilitation benefit of $10,033.92 for a chronic pain program.
The insurer denied the claim based on independent medical examinations suggesting the applicant had reached maximal medical recovery.
The Tribunal found the proposed treatment plan reasonable and necessary, preferring the evidence of the applicant's assessors which demonstrated ongoing pain and functional impairment exceeding physical signs of injury.
The appeal was allowed, and the insurer was ordered to pay the benefit with interest.
OLATOntario Licence Appeal TribunalSep 20, 2018