1The applicant was involved in an automobile accident on January 1, 2018, and sought benefits pursuant to the Statutory Accident Benefits Schedule - Effective September 1, 2010¹.The applicant was denied certain benefits by the respondent and submitted an application to the Licence Appeal Tribunal - Automobile Accident Benefits Service (“Tribunal”).

2The parties participated in a Case Conference on February 11, 2021 but did not resolve the issues in dispute.

ISSUES

3On consent, the following issues were agreed to at the Case Conference:

i. Are the applicant’s injuries predominantly minor, as defined in s.3 of the Schedule and therefore subject to treatment within the $3,500.00 limit and in the Minor Injury Guideline?

ii. Is the applicant entitled to a medical benefit in the amount of $3,046.27 for physiotherapy and massage therapy services, recommended by Complete Physiotherapy Centre, submitted on November 6, 2018 and denied on November 16, 2018?

iii. Is the applicant entitled to the cost of examination in the amount of $2,680.00 of an orthopaedic assessment, recommended by Dr. Bhargava, submitted on September 15, 2018 and denied on September 20, 2018?

iv. Is the applicant entitled to interest on any overdue payment of benefits?

LAW

4Section 3(1) of the Schedule states that a minor injury consists of one or more a sprain, strain, whiplash associated disorder, contusion, abrasion, laceration or subluxation and includes any clinically associated sequelae to such an injury. Section 3(1) of the Schedule also establishes the treatment framework regarding minor injuries.

5Section 18(2) of the Schedule provides that the $3,500.00 funding limit does not apply if an applicant provides compelling medical evidence that she has a pre-existing medical condition that will prevent her from achieving maximal recovery from the minor