Dr. Taverniti

The applicant was injured in a motor vehicle accident and sought payment for a functional capacity evaluation and a surface EMG under section 24 of the Statutory Accident Benefits Schedule.

The insurer refused payment, arguing the expenses were medical services subject to section 38 requirements or were experimental.

The arbitrator held that diagnostic assessments obtained to assist in preparing a treatment plan fall under section 24 and are not subject to section 38.

However, the arbitrator reduced the claimed amount by 50% because the quality and value of the reports were questionable due to missing pre-accident information and unexplained test results.

The applicant was awarded $637.50 plus interest and arbitration expenses.