The claimant sought entitlement to medical treatment plans. The claimant asserted a chronic pain diagnosis to justify the treatment plans. The insurer asserted that the chronic pain diagnosis was as a result of a pre-existing injury and not the MVA. Adjudicator Derek Grant ruled that although “but for” is the default test for causation, “material contribution” was needed since the argument was that the MVA triggered pre-existing conditions, resulting in chronic pain. It followed that the claimant had to prove that the MVA was more than a minimal contribution to the chronic pain diagnosis. Adjudicator Grant found the claimant suffered from chronic pain as a result of the MVA. All of the claimed treatment plans, with the exception of a brain electrical activity scan, were deemed reasonable.
