Blogs » Law and Legal Services » Deutshmann Personal Injury & Disability Law - PERSONAL INJURY & DISABILITY LAW BLOG
 

Blogs

Deutshmann Personal Injury & Disability Law - PERSONAL INJURY & DISABILITY LAW BLOG
Medical Marijuana is Considered Resonable and Necessary for Pain
Return to Blog 
Paquette Travers & Deutschmann, Personal Injury & Disability Lawyers Logo

Issues:

TN was catastrophically injured in a motor vehicle accident on October 29, 2000, when she was 21 years old. She applied for and received certain statutory accident benefits from Personal Insurance Company of Canada, payable under the Schedule.  Personal denied TN's claim for various other benefits. The parties were unable to resolve their disputes through mediation, and TN applied for arbitration at the Financial Services Commission of Ontario under the Insurance Act, R.S.O. 1990, c.I.8, as amended.

TN requested that her identity be anonymized in this decision. The Insurer consented to this request. Given the highly sensitive nature of the personal, family and medical information in this case, the Arbitrator found TN's request to be reasonable.

The issues in this hearing are:

  1. Is TN precluded from receiving income replacement benefits on the basis that she failed to apply for mediation and arbitration within two years of Personal's refusal to pay those benefits, pursuant to section 51(1) of the Schedule?
  2. Was TN employed or self-employed at the time of the accident?
  3. If TN was self-employed, is the rent of the family-owned barn to be added as losses from self-employment, pursuant to sections 6(5) and 6(6) of the Schedule?
  4. Did TN fail to submit an application for attendant care benefits to Personal within 30 days after receiving the application forms, contrary to section 32(3) of the Schedule, and, if so, what are the consequences of that failure?
  5. Did TN fail to submit an application for housekeeping benefits to Personal within 30 days after receiving the application forms, contrary to section 32(3) of the Schedule, and, if so, what are the consequences of that failure?
  6. If the answer to Issue 4 is "no", is TN entitled to attendant care benefits, from the date of the accident and ongoing, at the rate of $5,904.76 per month, pursuant to section 16(2) of the Schedule?
  7. If the answer to Issue 5 is "no", is TN entitled to housekeeping benefits from October 29, 2000 and ongoing, at a rate of $100 per week, pursuant to section 22(1) of the Schedule?
  8. Is TN entitled to nutritional counselling services, in the amount of $720, pursuant to sections 14(2)(h) and/or 15(5)(l) of the Schedule?
  9. Is TN entitled to medical and/or rehabilitation benefits for the purchase of medical marijuana, from December 14, 2005 and ongoing, at the rate of $1,200 per month, pursuant to sections 14(2)(h) and/or 15(5)(l) of the Schedule?
  10. Is Personal liable to pay TN a special award on the basis that it unreasonably withheld or delayed payments, pursuant to section 282(10) of the Insurance Act?
  11. Is TN entitled to interest on overdue benefits, pursuant to section 46 of the Schedule?
    Is either party entitled to its expenses of the arbitration, pursuant to section 282(11) of the Insurance Act?

Result:

  1. TN is not precluded from receiving income replacement benefits.
  2. TN was employed at the time of the accident.
  3. Given that TN was employed at the time of the accident, it is unnecessary to determine Issue 3.
  4. TN did not fail to submit an application for attendant care benefits as required, and is entitled to arbitrate her entitlement to those benefits.
  5. TN did not fail to submit an application for housekeeping benefits as required, and is entitled to arbitrate her entitlement to those benefits.
  6. TN is entitled to attendant care benefits from October 29, 2000 and ongoing, at the rate of $5,056.80 per month, less any amounts already paid by the Insurer.
  7. TN is entitled to two hours of housekeeping services per week, from May 1, 2008 and ongoing.
  8. TN is entitled to nutritional counselling services, in the amount of $720.
  9. TN is entitled to medical benefits for the purchase of medical marijuana, from March 27, 2007 and ongoing, at the rate of $567.60 per month.
  10. At the request of the parties, the issue of a special award will be addressed at a resumption of the hearing, if required.
  11. At the request of the parties, the issue of interest will be addressed at a resumption of the hearing, if required.
  12. The issue of expenses will be addressed at a resumption of the hearing, if required.

You can read the full decision on my personal injury blog.

 

Posted on Thursday, Jan 03, 2013 - 10:50:00 AM EST
 Comments  (0) Post a Comment 
   By Deutschmann Personal Injury & Disability Law - Visit Our Business Directory Listing  |   Return to Blog 

Blogs Home   |   Start a Blog   |   Subscribe To Blog
News   |   Announcements   |   Events Calendar
Contact The News Editor   |   News FAQs

 
    <<     September  2020     
S M Tu W Th F S
    1 2 3 4 5
6 7 8 9 10 11 12
13 14 15 16 17 18 19
20 21 22 23 24 25 26
27 28 29 30      
Jump to:

Article Categories
Disability Law
Car Insurance
Community
Law Enforcement
Personal Injury Law
Safety

Recent Articles
Drug Impaired Driving
Auto insurance deductibles unfair to seniors, homemakers, children and the disabled.
Should We Name and Shame Impaired Drivers?
Brain Injury and Psychiatric Illness
Women and Concussion
Feds Pushing Provinces to Stiffen Distracted Driving Laws
Government Proposing Tax on Employer Health Benefits
NFL Settles $30 Million CTE Lawsuit
Undiagnosed Concussions Common Following Car Accidents
Stunt Driving - What it is, What it will cost you
Construction Season Ramping Up, Again
Lawyer Fees
TBI Diagnosis with A Microwave Helmet
Are Ride Hailing Apps Reducing Drunk Driving Rates?
Using Microwaves to Catch Post TBI Brain Bleeds
Outdoor Adventures Aren't Without Dangers
Who has the right of way in designated cyclist lanes?
Are Young Athletes Really Ready to Return to Play Post-Concussion?
Spit Test May Indicate Severity of Concussions in Children
Wildlife strikes can be deadly

Articles by Month of Posting
January 2018
January 2017
January 2016
August 2015
July 2015
June 2015
May 2015
April 2015
March 2015
February 2015
January 2015
December 2014
November 2014
October 2014
September 2014
August 2014
July 2014
June 2014
May 2014
April 2014
March 2014
February 2014
January 2014
December 2013
November 2013
October 2013
September 2013
August 2013
July 2013
June 2013
May 2013
April 2013
March 2013
February 2013
January 2013
December 2012
August 2012
July 2012
May 2012
April 2012