Claim for TMJ treatment dismissed due to pre-existing injury; psychological services partially granted.
The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to treatment plans for temporomandibular joint (TMJ) treatment, a TMJ assessment, and psychological services.
The adjudicator dismissed the claims for TMJ treatment and assessment, finding the applicant failed to prove the dental injuries were caused by the subject accident rather than a prior collision.
The adjudicator partially granted the claim for psychological services, awarding $2,000.00 based on an appropriate hourly rate for a social worker, plus interest on the overdue amount.
The applicant's claim for an award under Regulation 664 for unreasonably withheld payments was dismissed, as the insurer's conduct was not found to be excessive or imprudent.
OLATOntario Licence Appeal TribunalAug 22, 2022
