Psychological treatment plan approved due to insufficient denial notice; other accident benefits denied for lack of causation.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied treatment plans for a chronic pain assessment, assistive devices, and psychological services.
The Tribunal found that the chronic pain assessment and assistive devices were not reasonable and necessary, noting significant delays in seeking treatment and a subsequent accident that raised causation issues.
However, the Tribunal granted the psychological services treatment plan, finding it reasonable and necessary based on the medical evidence, and noted that the respondent failed to provide sufficient reasons for its partial denial in contravention of s. 38(8) of the Schedule.
The applicant's claim for a special award was dismissed as the respondent's conduct was not unreasonable.
OLATOntario Licence Appeal TribunalJun 28, 2023
