The applicant, who sustained a moderate traumatic brain injury in a 2004 motor vehicle accident, sought attendant care benefits and medical benefits (a desk, chair, and mattress) from the respondent insurer.
The adjudicator preferred the evidence of the applicant's occupational therapist over the insurer's assessor, finding that the applicant required attendant care assistance for feeding, hygiene, exercise, and medication intake due to cognitive deficits and fatigue.
The adjudicator determined the reasonable monthly quantum for attendant care to be $666.23, but held that the benefits were not payable for the claimed period because the applicant had not actually received or paid for the services, meaning the expenses were not 'incurred' under the Schedule.
The adjudicator also approved the claimed medical benefits, finding the desk, chair, and mattress were reasonable and necessary to address the applicant's accident-related fatigue and disorganization.
