The claimant sought entitlement to two treatment plans, one for occupational therapy services and one for physiotherapy services. Adjudicator Manigat concluded that the denied treatment plans were not reasonable and necessary. With respect to the occupational therapy treatment plan, Adjudicator Manigat accepted that the claimant had to make certain adjustments to cope with some pain and use pacing strategies to resume her pre-accident activities. However, the adjudicator noted that any impact on the claimant’s ability to function had been remedied through the use of coping strategies, and that the claimant’s ongoing pain was not sufficient to render the treatment plan payable. With respect to the physiotherapy treatment plan, Adjudicator Manigat noted that the claimant had not submitted any physiotherapy requests for over 1.5 years prior to submission of the denied treatment plan, and there was no evidence to substantiate that further facility based treatment would result in additional benefit to the claimant.
