The claimant was injured in an accident on April 30, 2018. She sought entitlement to various treatment plans, including a chiropractic treatment plan submitted on May 15, 2018, and a physiotherapy treatment plan submitted on July 19, 2018. The insurer denied the claimant’s chiropractor treatment plan and partially approved the physiotherapy plan. The claimant was removed from the MIG on August 24, 2018. Adjudicator Deol held that the claimant was not entitled to the denied chiropractic treatment plan as it was properly denied under s. 38(5) of the Schedule, as the insurer was entitled to refuse a non-MIG treatment plan while the claimant was still within the MIG. In rejecting the claimant’s treatment plan for chiropractor treatment, the insurer clearly advised the claimant that their OCF-18 was being denied pursuant to ss. 38(5) and 38(6). However, Adjudicator Deol held that the insurer’s denial of the claimant’s physiotherapy treatment plan was not valid pursuant to s. 38(5). The insurer did not “refuse to accept” the disputed OCF-18, as it partially approved the OCF-18 and the denial letter did not reference ss. 38(5) and 38(6).
