17-001083 v Wawanesa Mutual Insurance Company, 2017 CanLII 87545

Dec 15, 2017

Adejudicator: Eleanor White

Issues:

1. Is the applicant entitled to a medical benefit in the amount of $1,819.32 for other assistive devices recommended by Dr. Justin Gray of Assess Medical Diagnostics Inc. in a treatment plan dated January 5, 2016, denied by the respondent on January 18, 2016?

2. Is the applicant entitled to a medical benefit in the amount of $1,914.51 for other assistive devices recommended by Dr. Amanda Louca of Toronto Medica Centre, in a treatment plan dated June 15, 2015, denied by the respondent on June 30, 2015?

3. Is the applicant entitled to a medical benefit in the amount of $5,450 for other assistive devices recommended by Dr. Justin Guy of Assess Medical Diagnostics Inc., in a treatment plan dated October 29, 2015, denied by the respondent on November 4, 2015?

4. Is the applicant entitled to receive a medical benefit in the amount of $3,067.20 for chiropractic services recommended by Dr. Aliya Salayeva of Health-Pro Wellness in a treatment plan dated October 15, 2015, denied by the respondent on November 4, 2015?

5. Is the applicant entitled to receive a medical benefit in the amount of $2,486.49 for psychological services recommended by Dr. Mehdi Lotfalizadeh of Assess Medical Diagnostics Inc., in a treatment plan dated May 16, 2016 denied by the respondent on June 9, 2016?

6. Is the applicant entitled to receive medical benefits in the amount of $5,450.00 for in-home physiotherapy services, recommended by Dr. Mitesh Rajodiyah from Assess Medical Diagnostics Inc., in a treatment plan dated March 24, 2016, denied by the respondent on June 9, 2016?

7. Is the applicant entitled to receive a medical benefit in the amount of $3,427.53 for in-home physiotherapy services, recommended by Dr. Mitesh Rajodiyah from Assess Medical Diagnostics Inc., in a treatment plan dated August 25, 2016, denied by the respondent on August 30, 2016?

8. Is the applicant entitled to payment for the costs of examinations in the amount of $3,658.50 for an orthopedic assessment, performed by Dr. Taj Getahun, Assess Medical Diagnostics Inc. dated June 30, 2015, denied by the respondent on July 20, 2015?

9. Is the applicant entitled to interest on the overdue amounts?

Results:

None of the treatment plans are deemed to be reasonable and necessary. The applicant has failed to satisfy his burden of demonstrating why he is entitled to the above. His alleged injuries are deemed not to be consistent with the mechanism of the accident.