Tamara was in a motor vehicle accident on December 16, 2014 and suffered a traumatic brain injury. This caused her to have post concussive syndrome along with symptoms of memory issues, trouble focusing, unsteady gait, involuntary muscle movements and lack of coordination on her left side along with several other symptoms. She still has residual problems including difficulty with fine motor skills that require continued treatment. She has seen multiple specialists for this. She is seeing Dr. Simkovich specifically for the post concussive syndrome symptoms. He is not providing any manipulation with her treatment. Give her symptoms and their severity, I feel that she requires this treatment and that it is medically necessary.