The claimant applied to the LAT to dispute entitlement to NEBs, various medical benefits, and an OCF-6 for clothing and eyewear. Adjudicator Neilson found that the claimant had not established that he suffered a complete inability to return to his pre-accident life .The claimant failed to include in his submissions evidence to support his claims for clothing and eyewear. Adjudicator Neilson granted $2,594 of a denied physiotherapy treatment plan because the insurer had failed to explain why it had reduced the approved hourly rate for the treatment. She denied the remaining $1,475.48 of the treatment plan because the claimant failed to provide evidence or reasons to refute the insurer’s IE report in which the assessor recommended that the claimant engage in self-directed exercises rather than physiotherapy. The claimant first complained of back pain nearly one year after the accident. Adjudicator Neilson stated that the claimant could not establish that the back pain was caused by the accident, given the length of time between the date of the accident and the claimant’s first complaint. She denied two treatment plans for physical therapy that were proposed in July 2020, over one year after the date of the accident. Adjudicator Neilson awarded the claimant the disputed treatment plan for psychological services. The insurer had refused the treatment plan on the basis that the claimant’s psychological impairments were not a “direct result” of the accident. Adjudicator Neilson found that s. 15 of the SABS required an impairment to be “a result” of the accident and not a “direct result”.
