The claimant sought entitlement to $16,320 for various catastrophic impairment assessments more than 10 years after his accident had occurred (and his medical benefits coverage had lapsed). The assessments were proposed after an OCF-19 had been submitted and IEs had taken place showing that the claimant did not suffer a catastrophic impairment. The insurer argued that the proposed assessments were rebuttal reports, and that the SABS did not provide coverage for such reports. Adjudicator Boyce held that the claimant did not have a vested right to pre-2010 SABS rebuttal reports, but that the proposed assessments were nevertheless payable. The assessments were not rebuttal reports, but rather first assessments which were necessary for the claimant to attempt to prove his claim. Adjudicator Boyce considered each proposed assessment and concluded that $2,000 per assessment was payable. He denied entitlement to the Essential Clinical Tasks fee and Medical File Review fee, as they were not reasonable and necessary.
