Attorney obtained a defense verdict in a recent PIP arbitration filed with National Arbitration Forum

Attorney obtained a defense verdict in a recent PIP arbitration filed with National Arbitration Forum. Claimant was seeking reimbursement of medical expenses for MRIs of the cervical and lumbar spine. The MRIs were performed only 8 days after the motor vehicle accident and 5 days after the patient began conservative chiropractic treatment. Defense attorneys argued that under N.J.S.A. 39:6A-2(m), "medically necessary" means that the treatment is consistent with the symptoms or diagnosis, and treatment of the injury (1) is not primarily for the convenience of the injured person or provider, (2) is the most appropriate standard or level of service which is in accordance with standards of good practice and standard professional treatment protocols, and (3) does not involve unnecessary diagnostic testing. According to the Care Paths set forth in N.J.S.A. 39:6A-4(a), MRI testing is appropriate if there are abnormal neurologic findings after 4 weeks of conservative treatment and/or after two weeks of conservative treatment without improvement. The DRP found that claimant failed to prove by a preponderance of the evidence that the cervical and lumbar MRI's performed one (1) week after the subject accident were medically necessary.