The claimant sought entitlement to NEBs, a social work assessment, the cost of completing three disability certificates, and interest. Adjudicator Boyce found that the claimant did not meet the stringent test to qualify for NEBs. The claimant stated that her pain improved with treatment and was not debilitating; she also reported independently carrying out her daily routines and self-care. As such, while Adjudicator Boyce acknowledged that test did not require the claimant to be bed-ridden, he held that the test demanded more evidence of impaired functionality and inability. Adjudicator Boyce did not find a social work assessment reasonable or necessary since there was no evidence that the assessment could address the claimant’s specific complaints. Adjudicator Boyce also did not find the cost of completing the three disability certificates to be reasonable or necessary since the insurer did not request them and they failed to provide new or additional information about the claimant’s impairments.
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