The claimant sought entitlement to the balance of a partially approved chronic pain assessment treatment plan and interest. Adjudicator Victor awarded the balance of the treatment plan, less transportation expenses, and interest on the overdue payment of benefits. Adjudicator Victor noted that she arrived at her decision largely in part due to the claimant’s credibility and supporting medical records that documented the claimant’s accident-related complaints. Adjudicator Victor noted that the claimant’s chronic pain affected his lifestyle and career, resulting in him taking significant time off work post-accident and him ultimately having to change employment to a job requiring lighter physical requirements. At the hearing, the insurer relied on IE reports to maintain that the balance of the disputed treatment plan was not payable. Adjudicator Victor criticized Dr. Oshidari’s IE report, calling it a “copy and paste” of an earlier report and that it was therefore, unreliable. Given the claimant’s ongoing pain complaints and the effect of his pain on his ability to function post-accident, Adjudicator Victor awarded the balance of the treatment plan for a chronic pain assessment, less transportation expenses, which were not payable under the SABS.
