1 total
Claim for adjustable bed and specialty bedding denied as not reasonable and necessary for recovery.
The applicant, who suffered a lower limb amputation in a motor vehicle accident, sought $8,000.49 for assistive devices including an adjustable bed, platform bed, and specialty bedding.
The respondent had partially approved the treatment plan for a memory foam mattress but denied the remaining items.
The Tribunal found that the applicant failed to prove the disputed items were reasonable and necessary.
Relying on the respondent's in-home occupational therapy assessment, the Tribunal concluded the applicant could safely transfer using his existing bedframe and that comfort alone did not satisfy the statutory criteria for funding.
