Dr. Jonathan Wareham

The applicant was injured in a motor vehicle accident and sought medical benefits for optometric services and an occupational therapy assessment under the Statutory Accident Benefits Schedule.

The respondent denied the benefits, arguing the applicant's impairments were caused by a pre-existing brain aneurysm and other life stressors rather than the accident.

The Tribunal applied the 'but-for' test for causation and found the accident was a necessary cause of the applicant's increased symptoms.

The Tribunal preferred the evidence of the applicant's treating practitioners over the respondent's assessor, concluding the proposed treatment plans were reasonable and necessary.

The applicant was awarded the claimed benefits.

The applicant sought statutory accident benefits following a motor vehicle accident.

The insurer denied treatment plans for optometric services and occupational therapy.

The Tribunal found that the applicant's impairments, including post-traumatic vision syndrome and headaches, were caused by the accident.

The Tribunal held that the optometric services were reasonable and necessary.

Furthermore, the Tribunal found that the insurer failed to provide proper medical reasons for denying the occupational therapy plan, violating s. 38(8) of the Schedule, and thus was required to pay for it under s. 38(11).

Both treatment plans were approved with interest.