Physiotherapy treatment plans denied because they included treatment for a non-accident-related intervening rotator cuff injury.
The applicant sought payment for two physiotherapy treatment plans following a 2015 motor vehicle accident.
The respondent denied the plans, arguing that they included treatment for a right rotator cuff injury that occurred in 2023 due to moving and heavy lifting, not the accident.
The Tribunal agreed, finding that medical evidence, including ultrasound and physiatry reports, confirmed the rotator cuff tear was an intervening, non-accident-related injury.
Because the treatment plans did not differentiate between accident-related and non-accident-related injuries, the applicant failed to prove the plans were reasonable and necessary.
The application was dismissed.
OLATOntario Licence Appeal TribunalMay 28, 2026
