Application for physiatry assessment dismissed as it was not reasonable and necessary and was duplicative.
The applicant was injured in a motor vehicle accident and sought funding for a physiatry assessment.
The respondent insurer denied the assessment, initially arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
Although the applicant was later removed from the MIG due to psychological injuries and chronic pain, the Tribunal found the physiatry assessment was not reasonable and necessary.
The assessment was proposed over two years before the chronic pain diagnosis, at a time when treating physicians only recommended physiotherapy.
Furthermore, the Tribunal found the proposed assessment would be duplicative of a chronic pain assessment already completed by the applicant's own medical expert.
The application was dismissed.
OLATOntario Licence Appeal TribunalFeb 17, 2022
