The applicant sought dispute resolution at the Licence Appeal Tribunal after the respondent insurer denied four treatment plans following a motor vehicle accident.
The adjudicator denied the request for an orthopaedic assessment, finding it was based solely on self-reported injuries without objective medical evidence.
Two chiropractic treatment plans were approved as reasonable and necessary because they included appropriate active and passive modalities consistent with the applicant's injuries.
A third chiropractic plan was denied due to a lack of substantive benefit and failure to address other barriers to recovery.
The applicant's claim for a special award under s. 10 of Regulation 664 was dismissed, but interest was awarded on the approved benefits.
