S.B. v. State Farm Insurance (17-003290)

The claimant sought entitlement to a number of medical benefits. On review, Adjudicator Christopher Ferguson determined that a number of treatment sought exceeded the monetary value claimed in the treatment plans, as well as in the Professional Service Guideline. Where the claims exceeded the PSGs, the treatment was not awarded. However, the remaining treatment plans, on review of the medical evidence were deemed reasonable and necessary.