Lisa Morell Kelly

The applicant sought entitlement to statutory accident benefits for physiotherapy, a chronic pain program, and occupational therapy following a motor vehicle accident.

The Licence Appeal Tribunal found that the applicant failed to prove the treatment plans for physiotherapy and the chronic pain program were reasonable and necessary, noting a lack of supporting clinical records and preferring the respondent's medical assessments.

The Tribunal partially approved the occupational therapy claim, granting entitlement to specific assistive devices such as ear plugs, sunglasses, and long-handled tools to mitigate the applicant's symptoms, but denied the occupational therapy sessions.

The applicant was injured in a motor vehicle accident and sought ongoing income replacement benefits (IRBs) and payment for various medical/rehabilitation treatment plans and assessments after the respondent insurer terminated them.

The Tribunal found that the applicant's radiculopathy and disc herniation were caused by the accident, rejecting the insurer's argument of an intervening event.

The Tribunal concluded the applicant met both the pre-104 week and post-104 week tests for IRBs, establishing a complete inability to engage in suitable employment.

However, the applicant failed to meet her burden to prove that the disputed treatment plans and assessments were reasonable and necessary.

The application was granted in part, with ongoing IRBs awarded.