Treatment plans for physiotherapy and assistive devices approved as reasonable and necessary for chronic pain.
The applicant sought statutory accident benefits following a 2014 motor vehicle accident.
The respondent insurer denied treatment plans for physiotherapy and assistive devices/occupational therapy.
The Licence Appeal Tribunal found that the proposed physiotherapy was reasonable and necessary given the applicant's chronic pain and fibromyalgia, preferring the recommendations of the applicant's treating practitioners over the insurer's assessors.
The Tribunal also approved the assistive devices based on a thorough in-home occupational therapy assessment.
The applicant was awarded the claimed benefits with interest, but the claim for a special award under s. 10 of Regulation 664 was dismissed as the insurer's conduct did not rise to the level of being unreasonable.
OLATOntario Licence Appeal TribunalNov 17, 2023
