Dr. Kertesz

The applicant sought entitlement to various medical and rehabilitation benefits under the Statutory Accident Benefits Schedule following a motor vehicle accident, including a massaging bathtub, a lightweight vacuum cleaner, physiotherapy, massage therapy, and a BrainEx group therapy program.

The respondent denied the treatment plans on the basis that they were not reasonable and necessary.

The Tribunal dismissed the application, finding that the applicant failed to meet her burden of proof.

The Tribunal preferred the objective medical evidence of the respondent's assessors, noting that the applicant's ongoing symptoms were largely attributable to pre-existing conditions such as fibromyalgia and chronic migraines, and that the requested treatments were either excessive in cost, unsupported by medical evidence, or unnecessary given the applicant's medical history.

The applicant was injured in a motor vehicle accident and sought various medical and rehabilitation benefits, as well as post-104 week income replacement benefits (IRB), which the respondent insurer denied.

The Licence Appeal Tribunal found that the applicant likely suffered a concussion and continued to experience dizziness, cognitive impairments, and psychological difficulties.

The Tribunal determined that the proposed treatment plans for occupational therapy, physiotherapy, and speech language therapy were reasonable and necessary, with the exception of a weighted vest.

Furthermore, the Tribunal concluded that the applicant met the test for post-104 week IRB, as her ongoing impairments rendered her completely unable to engage in any employment for which she was reasonably suited.

The respondent was ordered to pay the disputed benefits and interest.