What is the test for medical justification in a personal injury claim?

In Harrington v. Sangha, 2011 BCSC 1035 at para. 151, the court discusses the distinction between medical justification and medical necessity, noting the plaintiff need only prove the former to succeed: The distinction between medical justification and medical necessity is that the former requires only some evidence that the expense claimed is directly related to the disability arising out of the accident, and is incurred with a view toward ameliorating its impact. The latter test, necessity, would require the court to impose some standard other than reasonableness by asking not whether the expense is a reasonable one, but rather, whether there is any way in which it might be avoided. The latter test is inappropriate. It would impose upon the victim of an accident to be content with a state of affairs other than that which he or she would have occupied had they not been injured.

While expert evidence is necessary to establish the costs of future care, it need not be from a physician. The court must be satisfied, however, that an evidentiary link exists between a physician’s assessment of pain or disability and the recommended treatment and care: Gregory v. Insurance Corporation of British Columbia, 2011 BCCA 144 at para. 39.

Lastly, it is well settled law that in determining future events, the evidentiary burden is whether the plaintiff can prove there is a “real and substantial” possibility the costs will be incurred, rather than a balance of probabilities: Athey v. Leonati at para. 27.