Accident benefits claim dismissed; surveillance evidence and symptom magnification undermined applicant's self-reported inability to work.
The applicant sought statutory accident benefits, including income replacement benefits (IRBs) and funding for seven physiotherapy treatment plans, following a motor vehicle accident.
The Licence Appeal Tribunal dismissed the application in its entirety.
The adjudicator found the applicant's self-reporting to medical assessors unreliable due to symptom magnification and surveillance evidence showing the applicant working long hours at a restaurant.
Consequently, the applicant failed to prove a substantial inability to perform the essential tasks of his employment for pre-104 week IRBs, or a complete inability to engage in any employment for post-104 week IRBs.
The physiotherapy plans were deemed not reasonable and necessary, as the applicant contemporaneously reported to his family doctor that the treatments were ineffective.
OLATOntario Licence Appeal TribunalMar 10, 2025
