Application for accident benefits dismissed; applicant failed to prove entitlement to IRB, ACB, or treatment plans.
The applicant sought income replacement benefits (IRB), attendant care benefits (ACB), and approval for numerous treatment plans following a motor vehicle accident.
The Licence Appeal Tribunal dismissed the application in its entirety.
The Tribunal found the applicant failed to prove a substantial inability to perform her pre-accident employment as a cashier or a complete inability to work post-104 weeks, relying on video surveillance showing no physical distress and independent medical examinations.
The ACB claim was dismissed because the care was provided by family members who did not suffer an economic loss, and the benefit was not deemed incurred as it was not unreasonably withheld.
The disputed treatment plans were found not reasonable and necessary, as the medical evidence did not support the claimed injuries, including a concussion, and the applicant had reached maximum medical improvement.
OLATOntario Licence Appeal TribunalSep 9, 2022
