The claimant sought entitlement to income replacement benefits as well as psychological treatment plans. The insurer denied IRBs and asserted the claimant’s inability to resume working was due to a pre-existing injury and not an MVA-related impairment. The psychological treatment was denied by the insurer as being not reasonable and necessary. Adjudicator Deborah Neilson reviewed the medical evidence and noted that neither party tendered evidence from medical practitioners that addressed the claimant’s pre-existing conditions. Moreover, the claimant did not testify. Accordingly, it was held that the claimant failed to establish her impairments were directly as a result of the accident and prevented her from working. In the alternative, Adjudicator Neilson determined that the claimant failed to establish that she was substantially unable to resume working. As it pertained to the claim for psychological treatment, Adjudicator Neilson found that the treatment plan was necessary to address the claimant’s issues; however, based on the fees listed by the provider the plan was deemed unreasonable and therefore not payable.
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