The claimant sought entitlement to two treatment plans. Adjudicator Reilly denied entitlement to both. Regarding the first, she held that the insurer’s initial denial was deficient because it failed to provide any medical or other reasons, but that the insurer rectified the notice with a subsequent denial. Because the claimant had not incurred the assessment during the period prior to the proper denial, it was not payable. In terms of the second benefit, Adjudicator Reilly held that it was not reasonable and necessary. She accepted that pain relief was a valid treatment goal, but that the claimant had not demonstrated any improvement from hydrotherapy.
