Neurological assessment approved but other medical and rehabilitation benefits denied as not reasonable and necessary.
The applicant sought medical and rehabilitation benefits following a motor vehicle accident, which the respondent insurer denied.
The Licence Appeal Tribunal found that the applicant was entitled to the cost of a neurological assessment, as his treating physician diagnosed a nerve injury and the insurer's assessors lacked access to those medical records.
However, the Tribunal dismissed the claims for a chronic pain assessment, a Functional Ability Evaluation, psychological treatment, and transportation costs for an orthopaedic assessment, finding them not reasonable and necessary due to pre-existing conditions, lack of contemporaneous evidence, and unpersuasive expert reports.
The claim for a special award under Regulation 664 was also dismissed.
OLATOntario Licence Appeal TribunalSep 13, 2021
