The claimant sought full approval of an OCF-18 for psychological treatment in the amount of $3,491.48. The insurer had only approved $2,543.77 of the requested amount. The disputed treatment plan included 12, 1.5 hour sessions with psychologist Dr. Aghamohseni. The insurer had advised the claimant that it required additional information to justify approval of 1.5 hour sessions. The insurer had also reduced the approved amount when it became aware that, contrary to the information provided on the OCF-18, a portion of the treatment would be provided by Ms. Gharibi, a qualifying registered psychotherapist. Ms. Gharibi testified at the hearing that 45 minute sessions were sufficient and that the claimant was generally unable to sit for a longer period of time. Consequently, Adjudicator Lake agreed with the insurer and held that the claimant was not entitled to 1.5 hour sessions. She also found that the insurer’s reduced rate was reasonable, given Ms. Gharibi’s limited credentials and experience in providing psychological treatment.
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