An Ontario tribunal rejected a driver's bid for more psychological treatment - partly because he still hadn't used sessions TD General Insurance had already approved.
The applicant was injured in a March 1, 2023 accident in Keswick, Ontario, when his vehicle collided with a school bus. He sought statutory accident benefits, and a pre-existing shoulder tendinopathy removed him from Ontario's Minor Injury Guideline. The dispute reaching the Licence Appeal Tribunal centred on a $3,305 treatment plan for psychological services, proposed on July 22, 2024 by Safe Space Rehabilitation Centre, which TD General Insurance Company denied on September 30, 2024.
The denial came with an unusual wrinkle for claims teams: TD had already approved $3,710 for sixteen psychotherapy sessions on October 26, 2023. More than two years after the accident, the applicant had attended only fourteen of them. Adjudicator Greg Witt noted the record did not show that treatment had been exhausted, proven ineffective, or otherwise insufficient - undercutting the case for approving a fresh round on top of it.
The applicant pointed to several medical and rehabilitation reports diagnosing accident-related psychological impairment, including adjustment disorder with mixed anxiety and depressed mood and a single moderate episode of major depressive disorder, along with cognitive deficits affecting memory and concentration. He argued that without continued psychotherapy and cognitive-behavioural treatment, his condition could deteriorate and his recovery could stall.
TD's position rested heavily on its own psychological assessment, conducted September 14, 2024, with a report issued twelve days later. In it, the applicant denied significant ongoing depression, loss of interest, PTSD symptoms or vehicular anxiety, and described continued social engagement and functional relationships with family and coworkers. He also reported driving both his truck and motorcycle without anxiety. Asked directly about the proposed therapy sessions, he said he "was not sure he required the treatment," and later told the assessor he did not believe he had significant mental health concerns needing further care.
Witt found that the applicant's own self-report materially conflicted with his earlier records, including a psychological assessment from July 25, 2023 and a psychotherapy progress report from June 3, 2024, and said he had not offered a persuasive explanation for the inconsistency. The adjudicator also noted the proposed plan called for fourteen sessions of 1.5 hours each, though the applicant had previously described his sessions as typically lasting fifteen to forty-five minutes, and found the stated treatment goals - reducing pain and stress and improving coping - too broadly framed to show the additional sessions were reasonable and necessary.
The Tribunal dismissed the application on August 4, 2026, finding the applicant had not met his burden under sections 15 and 16 of the Statutory Accident Benefits Schedule. Because no benefits were found owing, no interest applied under section 51.
