(2) The rehabilitation benefit shall pay for reasonable and necessary measures undertaken by an insured person to reduce or eliminate the effects of any disability resulting from the impairment or to facilitate the insured person’s reintegration into his or her family, the rest of society and the labor market. O. Reg. 403/96, s. 15 (2).
(3) Measures to reintegrate an insured person into the labor market include measures that are reasonable and necessary to enable the person to,
(a) Engage in employment that is as similar as possible to employment in which he or she engaged before the accident; or
(b) Lead as normal a work life as possible. O. Reg. 403/96, s. 15 (3).
(4) In determining whether a measure is reasonable and necessary for the purpose of subsection (3), the insurer shall consider the insured person’s personal and vocational characteristics. O. Reg. 403/96, s. 15 (4).
(5) The rehabilitation benefit shall pay for all reasonable and necessary expenses incurred by or on behalf of the insured person as a result of the accident for a purpose referred to in subsection (2) for,
(a) Life skills training;
(b) Family counseling;
(c) Social rehabilitation counseling;
(d) Financial counseling;
(e) Employment counseling;
(f) Vocational assessments;
(g) Vocational or academic training;
(h) Workplace modifications and workplace devices, including communications aids, to accommodate the needs of the insured person;
(i) home modifications and home devices, including communications aids, to accommodate the needs of the insured person, or the purchase of a new home if it is more reasonable to purchase a new home to accommodate the needs of the insured person than to renovate the insured person’s existing home;
(j) Vehicle modifications to accommodate the needs of the insured person, or the purchase of a new vehicle if it is more reasonable to purchase a new vehicle to accommodate the needs of the insured person than to modify an existing vehicle;
(k) Transportation for the insured person to and from counseling and training sessions, including transportation for an aide or attendant;
(l) Other goods and services that the insured person requires, except services provided by a case manager. O. Reg. 403/96, s. 15 (5); O. Reg. 281/03, s. 4 (1).
(6) The insurer is not liable to pay a rehabilitation benefit for expenses related to professional services described in any of clauses (5) (a) to (g) or clause (5) (l) rendered to an insured person that exceed the maximum rate or amount of expenses established under the Guidelines applicable to the claim. O. Reg. 281/03, s. 4 (2).
(6.1) If the Guidelines applicable to the claim establish a range of rates or amounts for expenses related to professional services rendered to an insured person,
(a) the highest rate or amount in the range shall be deemed, for the purpose of subsection (6), to be the maximum rate or amount established under the Guidelines applicable to the claim; and
(b) an insurer that is liable to pay a rehabilitation benefit for expenses related to the services described in any of clauses (5) (a) to (g) or clause (5) (l) shall not pay less than the lowest amount or rate in the range unless the insured person’s claim is for less than the lowest amount or rate in the range. O. Reg. 281/03, s. 4 (2).
(7) For the purpose of clause (5) (i), expenses incurred to renovate the insured person’s home shall be deemed not to be reasonable and necessary expenses if the renovations are only for the purpose of giving the insured person access to areas of the home that are not needed for ordinary living. O. Reg. 403/96, s. 15 (7).
(8) The amount of the rehabilitation benefit for the purchase of a new home shall not exceed the value of the renovations to the insured person’s existing home that would have been required to accommodate the needs of the insured person. O. Reg. 403/96, s. 15 (8).
(9) For the purpose of clause (5) (j), expenses incurred to purchase or modify a vehicle to accommodate the needs of an insured person shall be deemed not to be reasonable and necessary expenses if they are incurred within five years after the last expenses incurred for that purpose in respect of the same accident. O. Reg. 403/96, s. 15 (9).
(10) The amount of the rehabilitation benefit for the purchase of a new vehicle shall not exceed the cost of the new vehicle, less the trade-in value of the existing vehicle. O. Reg. 403/96, s. 15 (10).
(11) Subject to subsection (12), the insurer is not liable to pay a rehabilitation benefit under clause (5) (k) for expenses related to transportation unless the expenses are authorized by, and are calculated by applying the rates set out in, the Transportation Expense Guidelines published in The Ontario Gazette by the Ontario Insurance Commission or Financial Services Commission of Ontario, as they may be amended from time to time. O. Reg. 403/96, s. 15 (11); O. Reg. 303/98, s. 2 (2).
(12) The insurer is not liable to pay a rehabilitation benefit under clause (5) (k) for expenses related to,
(a) the first 50 kilometers of transportation in the insured person’s automobile to and from a counseling or training session if the accident occurred before April 15, 2004; or
(b) The first 50 kilometers of transportation to and from counseling or training session if the accident occurred after April 14, 2004, unless the insured person sustained a catastrophic impairment as a result of the accident. O. Reg. 458/03, s. 5.
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