- Fracture (ribs)
- Health care (physiotherapy)
- Non-economic loss {NEL}
- Out of province (health care)
- Permanent impairment {NEL}
- Strains and sprains (lumbar)
The issues under appeal were: a) whether the worker had a permanent impairment (PI) from a low back sprain/strain and left 9th and 10th rib fractures; b) whether the worker was entitled to a non-economic loss (NEL) award; and, c) whether the worker was entitled to be reimbursed for expenses incurred for out-of-province physiotherapy treatments.
The appeal was allowed, in part. The Vice-Chair found that the evidence did not establish, on a balance of probabilities, that the worker had a PI with respect to the low back or the left ribs. There was no evidence presented of medical treatments, investigations, or an ongoing impairment related to the work accident over the nearly nine-year period between September 2014 and present. The REC report's prognosis for the worker was functional recovery and return to his pre-injury job at full hours in four weeks, which formed the basis for the Board's decision. These findings had not been contradicted by other medical investigations, and accordingly, there was insufficient medical basis for finding otherwise.Regarding the worker's expenses for physiotherapy treatments received in Portugal, OPM Document No. 15-06-07, "Leaving the Province/Country", provides that if treatment is sought by the worker while outside the province, the worker must obtain clinical reports and receipts for the treatment rendered. Failure to provide this information may result in reduction or suspension of benefits. The Board denied the worker's request for reimbursement because he did not provide clinical notes; however, the Vice-Chair noted that the policy refers to clinical reports, as opposed to clinical notes. In the Vice-Chair's view, the physiotherapist's statement that the worker underwent 25 treatments due to pain in the bilateral costal margins of the ribs with the dates of the treatments, met the requirement for a clinical report. OPM Document No. 15-06-07 provides that when treatment is sought outside the province/country, the worker may be paid the difference between the amount charged and the amount allowed under the Board's fee schedules.