The claimant sought entitlement to a treatment plan, which the insurer denied due to a MIG determination. The claimant asserted the insurer failed to comply with the Notice provisions of section 38 and that the claimant’s pre-existing psychological impairments warranted removal from the MIG. Adjudicator Gemma Harmison determined that the insurer failed to comply with section 38, by not providing Notice within 10 business days. In reviewing the chronology of events, it was noted that despite the date of the correspondence from the insurer, the fact that it was mailed added an additional five business days, thus falling outside the prescribed timelines. Accordingly, the insurer was barred from taking a MIG position. However, because none of the disputed treatment was incurred during the period following, no amounts were found payable. Instead, the treatment plan was evaluated on whether it was reasonable. On review of the evidence, the plan was deemed not reasonable and necessary.
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