Applicant awarded IRBs up to 104 weeks and partial assessment costs, but denied post-104 week IRBs.
The applicant was injured in a motor vehicle accident and sought income replacement benefits (IRBs) and the cost of a multi-disciplinary assessment from her insurer.
The insurer terminated IRBs after 104 weeks and denied the assessment costs.
The Licence Appeal Tribunal found that the applicant suffered a substantial inability to perform the essential tasks of her pre-accident employment as a restaurant crew member due to unresolved left shoulder tendonitis, entitling her to IRBs up to the 104-week mark.
However, the Tribunal concluded she did not meet the post-104 week test of a complete inability to engage in any suitable employment, relying on surveillance evidence and vocational assessments showing she could perform alternative jobs.
The Tribunal also awarded partial costs for the multi-disciplinary assessment, finding the occupational therapy, orthopedic, and vocational components reasonable and necessary, while denying the psychological and neurological components.
OLATOntario Licence Appeal TribunalOct 23, 2019
