Chronic pain assessment approved based on AMA Guide criteria; physiotherapy denied as home-based exercise preferred.
The applicant was injured in a rear-end motor vehicle collision and sought statutory accident benefits for a chronic pain assessment and physiotherapy.
The insurer denied the treatment plans.
The Tribunal found the chronic pain assessment was reasonable and necessary, relying on the applicant's family physician and the AMA Guide criteria for chronic pain syndrome.
However, the Tribunal dismissed the claim for physiotherapy, accepting the insurer's physiatry expert opinion that the applicant had already benefitted from facility-based treatment and would benefit more from home-based exercise.
Interest was awarded on the overdue payment for the chronic pain assessment.
OLATOntario Licence Appeal TribunalJun 29, 2023
