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Z.K. v. Unifund Assurance Company (18-007924)

  • January 8, 2020

The claimant sought entitlement to four physiotherapy treatment plans and the cost of an impairment assessment, a multi-disciplinary catastrophic assessment, and a neurological assessment. Adjudicator Manigat rejected the opinion of the insurer’s psychiatry assessor that there was no objective evidence of ongoing impairments and that the claimant did not have any functional limitations or physical restrictions, finding instead that the physiotherapy treatment plans were reasonable and necessary to manage the claimant’s chronic pain. The claimant was not entitled to the cost of the impairment assessment because a comprehensive impairment assessment had already been completed; nor was he entitled to the catastrophic assessment or neurological assessment, as his injuries were predominantly physical in nature.

Full decision here

TGP Analysis

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  • FILED UNDER Medical Benefits, CAT Assessments
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