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Applicant v. Allstate Insurance Company (16-004309)

  • January 11, 2018

The claimant sought entitlement to ongoing NEBs and two proposed treatment plans for physiotherapy. Adjudicator Baker denied entitlement to NEBs but awarded the treatment plans. In terms of NEBs, Adjudicator Baker wrote that the claimant had submitted only limited evidence about his pre-accident and post-accident life, which did not support entitlement to NEBs. He also wrote that the activities set out in the insurer’s IE (as reported by the claimant) suggested that the claimant did not suffer a complete inability to live a normal life. In terms of the treatment plans, Adjudicator Baker held that further physical therapy was reasonable and necessary for the claimant’s soft tissue pain particularly given that it allowed the claimant to be more active in her day to day tasks.

Full decision here

TGP Analysis

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  • FILED UNDER Medical Benefits, Non-Earner Benefits
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