The claimant sought medical benefits for an orthopaedic assessment and interest on the overdue payment of benefits. Adjudicator Watt held that the claimant was not entitled to the cost of the orthopaedic assessment. The claimant had a pre-accident history of fibromyalgia, anxiety disorder, lower back pain, right knee osteoarthritis, and was considered substantially disabled. Adjudicator Watt held that there was very little evidence, if any, differentiating between the claimant’s pre-accident injuries and post-accident injuries and the effect of the accident on the injuries. Adjudicator Watt held that the finding of soft tissue complaints did not necessitate an orthopaedic assessment. Additionally, the orthopaedic surgeon who submitted the treatment plan was unaware of the claimant’s pre-accident injuries. Further, Adjudicator Watt preferred the insurer’s orthopaedic surgeon’s report, which found no physical impairments.
Menu