2 total
Treatment plan for vision therapy approved as reasonable and necessary for accident-related post-concussive symptoms.
The applicant sought entitlement to a treatment plan for optometric services and vision therapy costing $4,686.00 following a motor vehicle accident.
The respondent denied the benefit based on an independent examination concluding there was no accident-related oculo-visual impairment.
The Tribunal found the applicant met his burden of proving the treatment was reasonable and necessary, relying on evidence from his treating optometrists and occupational therapist connecting his vision complaints to post-concussive symptoms.
The treatment plan was approved.
Application for accident benefits for optometric services dismissed as vision changes were found to be age-related.
The applicant sought statutory accident benefits for optometric assessments and services following a rear-end motor vehicle accident.
The insurer denied the treatment plans based on an independent medical examination by a neuro-ophthalmologist, who concluded the applicant's vision issues were age-related presbyopia rather than accident-related impairments.
The Tribunal applied the 'but for' test for causation and preferred the evidence of the insurer's neuro-ophthalmologist over the applicant's optometrist and physiatrist due to his specialized medical training.
The Tribunal found the treatment plans were not reasonable and necessary, and dismissed the application.
