Renate Eschlboeck

The applicant sought various medical and rehabilitation benefits under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The Licence Appeal Tribunal dismissed claims for amounts exceeding approved treatment plans and for services not covered by the Professional Service Guideline.

Claims for occupational therapy oversight of a fitness trainer and ongoing massage therapy were also dismissed as redundant or unnecessary, given the applicant had reached maximum medical improvement.

However, the Tribunal allowed the claim for a situational occupational therapy catastrophic impairment assessment, finding it distinct from an in-home assessment and necessary for a complete evaluation.

The insurer brought a motion to compel the insured to attend an in-person vocational assessment examination and to stay the arbitration hearing until she complied.

The insurer had previously obtained a paper review report from its vocational expert, who stated his conclusions were reliable and comprehensive.

The arbitrator found that the insurer's request, made more than four years after benefits were terminated and shortly before the hearing, was for hearing preparation rather than ongoing claims assessment.

The arbitrator concluded the examination was not reasonably necessary under section 42 of the Statutory Accident Benefits Schedule and allowed the arbitration to proceed.