Tribunal grants SABS benefits for aqua-therapy and chiropractic care but denies mattress and in-home assessment.
The applicant sought various medical and rehabilitation benefits under the Statutory Accident Benefits Schedule following a motor vehicle accident.
The respondent insurer denied several treatment plans, arguing they were not reasonable and necessary, largely due to the applicant's pre-existing conditions.
The Tribunal found that the applicant was not entitled to benefits for a new mattress or an in-home occupational therapy assessment, preferring the respondent's medical evidence on those issues.
However, the Tribunal granted the treatment plans for aqua-therapy, chiropractic services, and psychological assessments, finding them reasonable and necessary to address the applicant's accident-related pain and impairments.
The Tribunal also awarded a 50% special award on a nominal $87.19 chiropractic form completion fee, finding the respondent's denial of this standard fee to be unreasonable.
OLATOntario Licence Appeal TribunalOct 4, 2022
