3 total
Tribunal partially approves physiotherapy and assistive devices for chronic pain but denies income replacement benefits.
The applicant was injured in a motor vehicle accident and sought various statutory accident benefits, including income replacement benefits, treatment plans for physiotherapy and psychological services, assessments, and assistive devices.
The Licence Appeal Tribunal found that the applicant failed to prove entitlement to income replacement benefits, psychological services, and most assessments.
However, the Tribunal approved several physiotherapy plans and a portion of the requested assistive devices, finding them reasonable and necessary to manage the applicant's chronic pain.
The applicant's claim for a special award under s. 10 of O. Reg. 664 was dismissed, as the insurer's reliance on its assessors' reports was not unreasonable.
Application for chiropractic accident benefits dismissed as treatment plans were overlapping and not reasonable or necessary.
The applicant sought payment for three chiropractic treatment plans following a motor vehicle accident.
The respondent denied the benefits, arguing the treatments were not reasonable and necessary and pointing to the applicant's extensive pre-existing conditions, including fibromyalgia and chronic pain.
The Tribunal found that the applicant failed to meet his burden of proof, noting that the proposed treatment plans overlapped and duplicated services, reducing their reliability.
The Tribunal preferred the respondent's section 44 musculoskeletal assessment, which concluded the applicant had reached maximum medical improvement for soft-tissue injuries.
The application was dismissed, and no interest was awarded.
Application for accident benefits dismissed as injuries fell within the Minor Injury Guideline.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent insurer denied the claims, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and the $3,500 limit had been exhausted.
The applicant argued her pre-existing knee osteoarthritis, psychological impairments, and chronic pain removed her from the MIG.
The Tribunal found the pre-existing condition was not exacerbated by the accident and did not prevent maximal recovery.
The Tribunal also found insufficient medical evidence to support a psychological impairment or chronic pain diagnosis that would remove the applicant from the MIG.
The application was dismissed.
No co-appearing lawyers found.
No judges found.