The claimant and insurer disagreed over the payment of seven disputed medical and rehabilitation benefits, including the cost of IV injections, the cost of an EEG assessment, the cost of a functional abilities evaluation and the cost of a dietician assessment. The insurer submitted that the disputed benefits were not reasonable and necessary and relied on the conclusions of the IE assessors. Adjudicator Makhamra concluded that six of the disputed medical and rehabilitation benefits were payable, preferring the evidence of the claimant’s treating providers to the evidence of the IE assessors. Adjudicator Makhamra dismissed the claimant’s claim for a functional abilities evaluation preferring the evidence of the IE assessor that the claimant was self-limiting on examination and therefore, concluded that a FAE would be of little benefit to the claimant.
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