Applicant v. Aviva (16-000775)

The claimant had been involved in two accidents. He had been removed from the MIG due to pre-existing back injuries and sought entitlement to a treatment plan proposing psychological therapy in relation to the first accident. The treatment plan was submitted after the second accident occurred. Adjudicator White took issue with the treatment provider’s failure to mention to the second accident and failure to review the clinical notes and records of the family physician, as well as the claimant’s failure to seek out psychological treatment on his own. Surveillance was also considered by the adjudicator. The treatment plan was denied as being not reasonable and necessary.