The claimant and the insurer disagreed on the amount payable to a case manager. The claimant sought $150 per hour; the insurer argued that the Professional Services Guideline capped the hourly rate at $89.07. Adjudicator Maedel concluded that the PSGs applied to the services provided to the claimant, and that $89.07 was the maximum payable. Central to the decision was the determination that the claimant’s case managers were “qualified case managers” despite also being Registered Social Workers. Although the case managers had such professional designations, the services provided were in the nature of case management.
