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P.A. v. TD General Insurance Company (19-001349)

  • May 1, 2020

The claimant’s spouse and children were injured in an accident. He was not involved in the accident, but claimed he suffered from psychological impairments including post-traumatic stress (PTSD), anxiety, depression and insomnia as a result of the accident. He was prescribed medical cannabis to treat the accident related impairments. The insurer paid for the medical cannabis for a period of time and then denied further claims on the basis that the medication was not reasonable and necessary. Adjudicator Reilly ruled that that medical cannabis was reasonable and necessary as the claimant had not used cannabis for years prior to the accident, had consulted numerous doctors post-accident due to mental health issues, and had quit his job to take care of his wife and children and produced numerous medical records showing psychological diagnosis post-accident as well as references to the cannabis being used to treat his post-accident conditions, which was the predominant purpose of the prescriptions.

Full decision here

TGP Analysis

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  • FILED UNDER Medical Benefits
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