Licence Appeal Tribunal File Number: 21-010877/AABS
In the matter of an application pursuant to subsection 280(2) of the Insurance Act, RSO 1990, c I.8, in relation to statutory accident benefits.
Between:
Filomena Caselle
Applicant
and
Aviva Insurance Company
Respondent
DECISION
ADJUDICATOR:
Lisa Yong
APPEARANCES:
For the Applicant:
Maria Makarova, Paralegal
For the Respondent:
Yann Grand-Clement, Counsel
HEARD: In Writing
OVERVIEW
1Filomena Caselle, the applicant, was involved in an automobile accident on November 26, 2019, and sought benefits pursuant to the Statutory Accident Benefits Schedule – Effective September 1, 2010 (including amendments effective June 1, 2016) (the “Schedule”). The applicant was denied benefits by the respondent, Insurer, and applied to the Licence Appeal Tribunal – Automobile Accident Benefits Service (the “Tribunal”) for resolution of the dispute.
ISSUES
2The issues in dispute are:
i. Is the applicant entitled an income replacement benefit of $400.00 per week from November 27, 2021 to April 12, 2022, submitted on June 28, 2021?
ii. Is the applicant entitled to $84.75 ($95.73 less $10.98 approved) for medical cannabis proposed by Dr. Mahoney in an OCF-6 dated August 10, 2021, submitted on August 10, 2021?
iii. Is the applicant entitled to $107.35 for medical cannabis in an OCF-6 submitted on April 30, 2021?
iv. Is the applicant entitled to $2,587.49 for an in-home ergonomic assessment proposed by Tier 1 Assessments in a treatment plan/OCF-18 (“plan”) submitted on April 24, 2020?
v. Is the applicant entitled to $2,327.49 for a work site ergonomic assessment, proposed by Tier 1 Assessments in a plan submitted on July 3, 2020?
vi. Is the applicant entitled to $3,622.73 for physiotherapy services, proposed by Mackenzie Medical in a plan submitted on June 13,

