This preliminary issue hearing was brought to determine whether the claimant was statute barred from proceeding with his appeal of a number of medical benefits and expenses because he did not submit treatment plans before incurring the expenses, and because he did not attend an IE that the respondent had determined was necessary for it to consider the benefits. Adjudicator Makhamra concluded that the claimant could proceed with his appeal of an expense for foot orthotics, as it fell under one of the exceptions under section 38 of the SABS which states that expenses for goods under $250 are not required to be submitted through a treatment plan. However, the adjudicator found that the claimant was barred from proceeding with the remaining issues because he was required to submit a treatment plan before incurring them, and did not do so. The adjudicator also found that the claimant’s failure to attend the reasonably necessary and properly scheduled IE prevented his dispute from proceeding to a hearing.
Menu