The insurer denied a number of treatment plans and costs of three assessments based on its finding that the claimant’s injuries fell within the MIG. Adjudicator Boyce found that the claimant suffered from chronic pain which entitled him to treatment beyond the MIG. All of the medical benefits for physiotherapy were found reasonable and necessary. The claimant’s evidence showed that his chronic pain caused functional impairment based on its severity and persistence, which affected his daily and work life over two years post-accident. Adjudicator Boyce went on to hold that the claimant was entitled to the cost of an impairment assessment but not the costs of examinations for in-home assessments or psychological assessments as they were not reasonable or necessary.
Menu