Application for accident benefits and special award dismissed; treatment plan not proven reasonable and necessary.
The appellant sought payment for a physical rehabilitation treatment plan and a lump sum award for a chronic pain assessment under the Statutory Accident Benefits Schedule following a motor vehicle accident.
The adjudicator found that the appellant failed to prove the physical rehabilitation treatment was reasonable and necessary, noting a lack of evidence showing prior treatments were beneficial.
The request for a lump sum award was also denied, as the insurer had provided proper medical reasons for denying the chronic pain assessment before the expense was incurred, and thus did not unreasonably withhold or delay payment.
The application was dismissed.
OLATOntario Licence Appeal TribunalJan 31, 2019