D.G. v. Allstate Insurance Company of Canada (17-001641)

The claimant sought entitlement to one treatment plan for physiotherapy services. The respondent relied upon the orthopaedic IE report of Dr. Yousif, in which he concluded that the claimant did not require further treatment. The claimant provided only two documents with his written submissions: the Motor Vehicle Accident Report prepared by the police and the OCF-18 in dispute, which provided no information with respect to the claimant’s prognosis. Adjudicator Maedel found the IE report more comprehensive and persuasive than the claimant’s evidence, given the scope and detail provided. The adjudicator concluded that the claimant was not entitled to the medical benefit, as he had not met his onus of establishing that the disputed treatment plan was reasonable and necessary.