P. Kedar

The applicant sought income replacement benefits (IRBs) and attendant care benefits (ACBs) following a motor vehicle accident.

The adjudicator found that while the applicant met the pre-104 week disability test for IRBs as a server, she failed to establish the quantum of her entitlement because she did not produce her 2016 Notice of Assessment or post-accident tax returns.

The adjudicator drew an adverse inference from this failure to produce material financial documents.

The claim for ACBs was also dismissed because the applicant provided no evidence that she had actually incurred the expenses.

The application was dismissed in its entirety.

The applicant sought statutory accident benefits following a rear-end motor vehicle collision.

The respondent insurer denied several treatment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant's diagnosed psychological injury (Adjustment Disorder) removed them from the MIG, despite the applicant's reported disinterest in psychological treatment.

While the Tribunal approved the psychological assessment and treatment plans, it denied the physiotherapy, assistive devices, and chronic pain plans, finding them not reasonable and necessary based on the medical evidence.

The Tribunal also ordered the respondent to pay an award of $1,110.95 under O. Reg. 664 for unreasonably withholding the psychological benefits by misinterpreting the Schedule.