Yes! As it should be! Pain relief treatment after a car accident in Ontario is not only common, it may also be legally justified under Ontario’s accident benefits system.
In Skinner v. Economical Insurance Company (2025 ONLAT), the Licence Appeal Tribunal reaffirmed an important principle for Accident Benefits practitioners. This states that pain relief can justify ongoing treatment. This is true even where an insurer argues that an insured person has plateaued or reached maximal medical recovery.
Why Pain Relief Matters in an Ontario Treatment Plan
In Skinner the applicant was injured in a motor vehicle accident. They sought entitlement to further physiotherapy via a Treatment and Assessment Plan (OCF-18). The insurer had previously funded prior physiotherapy treatment. The insurer denied the subsequent plan, arguing that the applicant’s soft tissue injuries had largely healed, that no meaningful functional improvement was likely, and that additional treatment was therefore not reasonable or necessary under Ontario accident benefits law.
This position reflects a common defence in LAT disputes: insurers often approve multiple treatment plans before denying continuation on the basis that further recovery is unlikely.
However, the Tribunal rejected this narrow approach.
What the Tribunal Said About Pain Relief and Treatment Goals
Adjudicator Rasha El Sissi emphasized that under the Statutory Accident Benefits Schedule, the proper question is whether the treatment remains reasonable and necessary, not whether it will produce complete recovery.
Importantly, the applicant’s physiotherapy plan explicitly identified “pain reduction” as one of its treatment goals, consistent with Part 9 of the OCF-18, which specifically recognizes pain reduction as a legitimate objective of treatment planning.
The evidence demonstrated that the applicant continued to experience chronic musculoskeletal pain, headaches, and functional limitations affecting work and daily life. Both the treating physiotherapist and section 25 and 44 experts acknowledged subjective reporting that physiotherapy provided temporary but meaningful symptom relief, reducing pain by 30–50% for several days following treatment.
Can Pain Relief Justify Ongoing Physiotherapy in Ontario?
The Tribunal held that “managing his symptoms of MSK-related pain is a legitimate goal of treatment.”
This finding is particularly significant because it confirms that treatment does not become unreasonable simply because an applicant has reached a recovery plateau. Where there is clear evidence that treatment continues to provide symptom management, functional support or pain reduction, it may still meet the reasonable and necessary test.
Ultimately, the applicant was awarded the full cost of the treatment plan plus interest.
Key Takeaways for Personal Injury Lawyers and Accident Victims
- “Pain reduction” is expressly recognized in the OCF-18 as a valid treatment goal
- Insurers cannot rely solely on “maximal medical recovery” arguments where ongoing treatment continues to provide meaningful symptom relief
- Temporary pain management may still satisfy the reasonable and necessary treatment threshold;
- Treatment plans should clearly document symptom relief, functional benefits, and real-world improvements;
- Accident benefits are not limited to curative care; rehabilitative and symptom management are equally legitimate.
Questions About Denied Physiotherapy or Accident Benefits in Ontario?
If your treatment has been denied following a motor vehicle accident, understanding your rights early can make an important difference.
Our Ottawa and Eastern Ontario personal injury lawyers can review your situation, explain the accident benefits process and help determine whether denied treatment may still qualify as reasonable and necessary under Ontario law. Contact our office today to arrange a free consultation.
