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M.S. v. Aviva General Insurance Company (18-007082)

  • March 6, 2020

The claimant sought entitlement to four treatment plans for medical rehabilitation and cost of examinations, including chiropractic treatment, concussive therapy, and optometric services. Vice-Chair McQuaid found that the proposed treatments were not payable. In her decision, she noted that, although, she gave more weight to the evidence provided by the claimant’s family physician and treating practitioners over the IE assessors, the records and evidence provided by the claimant did not contain any recommendations by the family physician for any of the disputed treatment plans for physical therapy. The remaining treatments for optometric services were denied as the claimant had pre-existing cataracts, which were not caused by the subject accident, and the medical records indicated that, although concussive symptoms were present, that they had fully resolved by the time the concussive therapy was proposed.

Full decision here

TGP Analysis

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  • FILED UNDER Medical Benefits
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