3 total
Tribunal awards medical and rehabilitation benefits for optometric and speech therapy, but denies gaming computer.
The minor applicant was struck by a dump truck while in a stroller in 2010.
He sought statutory accident benefits for various treatment plans, which the respondent insurer denied based on insurer examinations.
The Licence Appeal Tribunal found the applicant was entitled to optometric services, speech language therapy, and certain assistive devices (a curved monitor and wobble stool), preferring the evidence of the applicant's treating practitioners over the respondent's paper reviews.
However, the Tribunal denied funding for a gaming computer and a YMCA summer camp/membership, finding them not reasonable and necessary.
Interest was awarded on the overdue benefits.
Application for accident benefits dismissed as proposed treatment plans were not reasonable and necessary.
The applicant was injured in a motor vehicle accident and sought various medical and rehabilitation benefits under the Statutory Accident Benefits Schedule, which the respondent insurer denied.
The applicant applied to the Licence Appeal Tribunal to dispute the denials of treatment plans for physiotherapy, a neuro-optometric assessment, an orthopaedic assessment, and a functional abilities evaluation.
The Tribunal found that the disputed treatment plans were not reasonable and necessary, relying heavily on the respondent's insurer's examinations which concluded the applicant had reached maximum medical recovery and required no further intervention.
One physiotherapy treatment plan had already been approved by the respondent prior to the hearing.
The Tribunal dismissed the claims for the remaining benefits, interest, a special award, and costs.
Tribunal approves medical marijuana and select treatment plans; dismisses insurer's motion to stay for unrelated missed examinations.
The applicant sought various medical and rehabilitation benefits following a motor vehicle accident.
The respondent brought a preliminary motion to dismiss or stay the application because the applicant failed to attend insurer examinations related to a catastrophic impairment determination.
The adjudicator dismissed the motion, finding the missed examinations were irrelevant to the specific treatment plans currently in dispute.
On the substantive issues, the adjudicator approved a functional oculo-visual assessment, one course of chiropractic treatment, and expenses for medical marijuana and CBD oil, finding them reasonable and necessary based on the medical evidence.
The remaining treatment plans, including a chronic pain assessment, a second vision therapy assessment, and further chiropractic treatment, were denied for lack of supporting evidence or because they were premature or redundant.
The applicant's claim for a special award was also dismissed.
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