Applicant barred from non-earner benefits claim due to limitation period; partial treatment plans and 10% award granted.
The applicant sought statutory accident benefits following a 2017 motor vehicle accident.
The adjudicator found that the applicant was barred from proceeding with her claims for non-earner benefits and an OCF-18 for assistive devices because she failed to commence her application within the two-year limitation period under s. 56 of the Schedule.
The adjudicator granted the OCF-18s for a physiatry assessment and chiropractic treatment, finding them reasonable and necessary to address ongoing pain complaints, and noted that the insurer's assessors lacked key medical records.
The remaining OCF-18s and a claim for an OCF-3 were dismissed.
The adjudicator awarded the applicant 10 percent of the payable OCF-18s under s. 10 of Regulation 664, finding the insurer's continued reliance on incomplete assessment reports to be inflexible.
OLATOntario Licence Appeal TribunalMay 8, 2023
