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Insured entitled to most disputed medical benefits for chronic pain and psychological impairments; FAE denied.
The applicant sought various medical and rehabilitation benefits following a motor vehicle accident, which the respondent insurer denied.
The Licence Appeal Tribunal found that the treatment plans for lidocaine injections, an EEG assessment, physiotherapy, a dietician assessment, assistive devices, and psychological services were reasonable and necessary to treat the applicant's chronic pain and psychological impairments.
The Tribunal denied the functional abilities evaluation due to the applicant's pain-focused behaviour rendering it inaccurate, and dismissed the claim for a Regulation 664 award.
Pre-104 week IRBs and assistive devices awarded; post-104 week IRBs denied as applicant returned to part-time work.
The applicant was injured in a motor vehicle accident and sought income replacement benefits and medical benefits from the insurer.
The arbitrator found the applicant suffered a substantial inability to perform the essential tasks of her employment as an educational assistant and awarded pre-104 week income replacement benefits.
However, the arbitrator dismissed the claim for post-104 week income replacement benefits, finding the applicant did not suffer a complete inability to engage in suitable employment, as she had returned to work part-time.
The arbitrator also awarded medical benefits for assistive devices, including a soaker tub, mattress, ergonomic desk, and treadmill, but denied the claim for physiotherapy and yoga.
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