Application for accident benefits dismissed as treatment plans were not reasonable and necessary.
The applicant sought medical and rehabilitation benefits for chronic pain treatment and physiotherapy following a motor vehicle accident.
The respondent insurer denied the treatment plans on the basis that the applicant had reached maximum medical improvement.
The Licence Appeal Tribunal found that the applicant's medical evidence lacked precision and failed to link the proposed treatments to the accident or demonstrate how they would improve his function.
Relying on the respondent's medical assessors, who concluded the applicant's injuries had resolved, the Tribunal held the treatment plans were not reasonable and necessary.
The claim for a chronic pain assessment was also dismissed because the applicant failed to submit the required Treatment and Assessment Plan (OCF-18).
The application was dismissed in its entirety.
OLATOntario Licence Appeal TribunalAug 15, 2017
