What is the impact of recommendations made by a qualified health care professional on determining whether an item or service is medically justified?

British Columbia, Canada


The following excerpt is from Gabor v. Boilard, 2015 BCSC 1724 (CanLII):

Recommendations made by health care professionals are relevant in determining whether an item or service is medically justified: Gregory at para. 38. However, to successfully advance a future cost of care claim it is not necessary that a physician testify to the medical justification of each and every item of care that is claimed. What is required is some evidentiary link between the physician’s assessment of pain, disability, and recommended treatment and the care recommended by a qualified health care professional: Gregory at 39; Gignac at paras. 31-32; Aberdeen v. Zanatta, 2008 BCCA 420 at paras. 43‑53, 63. General contingencies and those specific to the plaintiff are to be taken into account where and as appropriate: Gignac at para. 52.

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