Andy Avram (Charlotte) recently prevailed in an interesting administrative motion related to unauthorized medical treatment. Plaintiff, upon prescription of a Sleep Number bed by the treating physician, purchased a Tempur-Pedic bed. The bed was prescribed due to Plaintiff’s chronic pain and inability to sleep at night. At the time of the purchase the Carrier was considering the authorization request, but had not approved the purchase. Plaintiff, by and through counsel, filed a Motion with the IC for the Carrier to pay for the bed that had already been purchased.
Defendants responded to the Medical Motion by asserting that there was no clear indication from the treating physician that the bed would effect a cure or provide relief to plaintiff. Moreover, Plaintiff should have allowed Defendants to apply the fee schedule to the purchase of the bed in the event it was determined to be reasonable medical treatment.
The Industrial Commission denied Plaintiff’s Motion based on Andy’s arguments.
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