The claimant sought entitlement to NEBs, ACBs, and medical benefits. The insurer argued that the claimant failed to attend IEs; the claimant responded that the IEs were not reasonably required and several were requested after the LAT application. Adjudicator Mazerolle agreed with the insurer. He held that the IE notices provided the medical reason for the assessments – namely, that the insurer had received section 25 assessments with new information which required updated medical opinions. He also held the timing of the requests was appropriate based on the timing of the section 25 assessments. However, he held that an IE was not needed to determine if prescription expenses were reasonable and necessary because there was prejudice to the claimant if the psychiatric medications were not paid for.
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