Dr. K. Prutis

The applicant sought medical benefits for four chiropractic treatment plans following a motor vehicle accident.

The adjudicator found that the applicant failed to establish that the ongoing low back pain was caused by the accident, noting a delay in reporting musculoskeletal complaints and affording little weight to the applicant's physiatrist.

Relying on the insurer's orthopedic examination, the adjudicator concluded the treatment plans were not reasonable and necessary.

The claims for the treatment plans, an award, and interest were dismissed.

The applicant was injured in a motor vehicle accident and sought income replacement and housekeeping benefits from his insurer.

The insurer terminated benefits, arguing the applicant failed to attend an insurer's examination and was no longer disabled.

The arbitrator found the applicant had a reasonable excuse for missing the examination due to confusing correspondence and language barriers.

The arbitrator awarded income replacement benefits for the initial period and up to February 17, 2004, finding insufficient evidence of disability beyond that date, as the applicant's leg numbness was likely a benign condition.

Housekeeping benefits were awarded at a reduced rate of $20 per week based on an in-home assessment, as the applicant's evidence regarding his pre-accident housekeeping was vague and unsupported.