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Insurer waived signature requirement on treatment plans; chiropractic and occupational therapy benefits awarded for chronic pain.
The applicant sought statutory accident benefits for chiropractic, psychological, and occupational therapy services following a 2006 motor vehicle accident.
The insurer denied the treatment plans and raised a preliminary issue that the plans were initially unsigned.
The Tribunal held that the insurer waived the signature requirement by failing to raise it in the initial denial letters.
On the merits, the Tribunal found the chiropractic and occupational therapy plans were reasonable and necessary to address the applicant's chronic pain, though mileage expenses for the occupational therapist were excluded.
The psychological treatment plans were denied due to insufficient evidence of ongoing psychological distress and the applicant's failure to attend previously approved sessions.
Insurer ordered to pay caregiver benefits and an $8,000 special award for unreasonably terminating psychological counselling.
The applicant was injured in a motor vehicle accident and claimed ongoing caregiver benefits, housekeeping expenses, psychological counselling, and a special award after the insurer terminated her benefits.
The arbitrator found that the applicant suffered a substantial inability to perform caregiver tasks due to physical and psychological impairments until her condition stabilized in January 1999, awarding caregiver benefits for that period.
The arbitrator also awarded a nominal amount for housekeeping expenses and an $8,000 special award, finding the insurer unreasonably terminated psychological counselling and vocational retraining benefits without a reasonable basis.
No co-appearing lawyers found.
No judges found.