The insurer requested reconsideration of a decision in which the Tribunal found the claimant was entitled to partial payment of the cost of multidisciplinary CAT assessments and fees for the completion of the OCF-18 and OCF-19. Adjudicator Braun denied the request for reconsideration. The insurer argued that a chiropractor was not authorized to provide an opinion to a number of the conditions listed in Part 6 of the treatment plan, and in particular, mental and cognitive impairments, and that doing so invalidated the chiropractor’s certification in Part 4 that the assessments were reasonable and necessary. Adjudicator Braun found that the OCF-18 complied with s.38(3)(c). Adjudicator Braun agreed that it would be beyond a chiropractor’s scope of practice to opine on cognitive functioning. However, it was Adjudicator Braun’s view that recommending that a person with an impairment or a suspected impairment be assessed by a relevant specialist was different than offering an opinion regarding that impairment and or recommending treatment. In this case, the chiropractor only stated that it was reasonable and necessary to have a CAT assessment conducted by a team of qualified physicians and health professionals and did not offer any opinion on the claimant’s functional abilities in any of the areas listed in Part 6. The insurer’s position that some of the conditions listed in Part 6 were outside of the chiropractor’s scope, was an overly technical view , which failed to consider the OCF-18 as a whole. In this case, the OCF-18 represented an effort of a chiropractor and a neurologist from the same assessment facility who jointly made the recommendation for an assessment to determine CAT threshold. Adjudicator Braun further found that it was within the chiropractor’s scope of practice to make the statement in Part 4 although she was not authorized to treat some of the injuries listed in Part 6. In this case, the chiropractor did not offer a medical opinion or any treatment recommendations, but stated that it was reasonable and necessary for the claimant to pursue and assessment related to the injuries listed in Part 6. The insurer also argued that the certification of the chiropractor to provide an executive summary and WPI rating did not expand the scope of her practice beyond what is stated in the Chiropractor Act and the executive summary and WPI report constituted an assessment of CAT for the purposes of s.45 of the SABS that did not allow a chiropractor to perform such an assessment. Adjudicator Braun noted that executive summaries and WPI reports compiled by chiropractors was not new in cases before the Tribunal and in her view, the executive summary and WPI rating was simply a written summarization of opinions already provided and did not provide any fresh opinion. The insurer further argued the OCF-18 was a rebuttal to the insurer’s CAT IEs. The claimant OCF-18 indicated the treatment plan was to rebuttal IE multidisciplinary CAT impairment report. Adjudicator Braun found that the words “to rebut” in the OCF-18 was semantic, and even though the IE reports were conducted first, it did not render the assessments claim in this case true rebuttals. The assessments were clearly the claimant’s first and only set of assessments that applied for a CAT determination under s. 45.
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