Foujan Rahmati

The applicant sought income replacement benefits (IRBs) and medical and rehabilitation benefits following a motor vehicle accident.

The adjudicator found that the applicant failed to prove she suffered a substantial inability to perform the essential tasks of her pre-accident employment, noting inconsistencies in her reported employment and a lack of supportive medical evidence linking her physical and psychological impairments to the accident.

Furthermore, the applicant was found non-compliant with section 33 of the Schedule for failing to provide requested employment and income documentation.

The adjudicator also dismissed the claims for physiotherapy, psychological services, and a chronic pain program, finding the applicant did not establish that the treatments were reasonable and necessary or that she suffered from accident-related chronic pain.

The application was dismissed in its entirety.

The applicant sought statutory accident benefits following a motor vehicle accident.

The Tribunal denied the non-earner benefit, finding the applicant failed to prove a complete inability to carry on a normal life.

The Tribunal approved two physiotherapy treatment plans and a psychotherapy treatment plan, finding them reasonable and necessary based on the medical evidence.

A chronic pain treatment plan was denied as the applicant did not meet the criteria for chronic pain with functional limitations.

The Tribunal also ordered a 15% award under s. 10 of Regulation 664, finding the insurer unreasonably withheld benefits by ignoring its own assessor's diagnosis and inflexibly dismissing a treatment plan over a signature issue.