Tribunal File Number: 17-005228/AABS
Case Name: 17-005228 v Toronto Transit Commission
In the matter of an Application pursuant to subsection 280(2) of the Insurance Act, RSO 1990, c I.8, in relation to statutory accident benefits.
Between:
Applicant
Applicant
and
Toronto Transit Commission
Respondent
DECISION
ADJUDICATOR: Kimberly Parish
APPEARANCES:
For the Applicant: Self-represented
Counsel For the Respondent: Tamara Broder
Heard: in Person on: June 11 and 12, 2018
OVERVIEW
1A.W (“the applicant”) was injured in a motor vehicle accident (“the accident”) on June 22, 2015. The applicant applied to the Toronto Transit Commission (“TTC”) for accident benefits under the Statutory Accident Benefits Schedule - Effective September 1, 20101 (the ''Schedule'').
2TTC paid for the medical benefits for which the applicant applied, but denied the applicant’s request for a non-earner benefit (“NEB”) and attendant care benefit (“ACB”). TTC’s position is that she did not meet the statutory requirements outlined within the Schedule and is therefore not entitled to payment for these benefits. The applicant then applied to the Licence Appeal Tribunal – Automobile Accident Benefits Service (the “Tribunal”) when her claims for benefits were denied by the TTC.
3The appeal filed by the applicant with the Licence Appeal Tribunal is now before me. This matter was heard at an in-person hearing. Each side provided their evidence which differed surrounding the entitlement to these benefits. Upon review of the evidence before me, I find the applicant is not entitled to the benefits claimed.
ISSUES
4The issues before the Tribunal which I must decide on are:
(1) Is the applicant entitled to receive a non-earner benefit for $185.00 per week from January 21, 2016 to date and ongoing?
(2) Is the applicant entitled to an attendant care benefit for $3,000.00 per month from June 22, 2015 to June 21, 2017?
(3) Is the applicant entitled to interest on any overdue payment of benefits?
RESULT
5Based on the evidence before me, I find that:
(1) The applicant is not entitled to a non-earner benefit in the amount of $185 per week from January 21, 2016 to present.
(2) The applicant is not entitled to an attendant care benefit for $3,000.00 per month from June 22, 2015 to June 21, 2017.
(3) As no benefits are payable, the applicant is not entitled to any interest.
BACKGROUND
6The applicant was a passenger riding on a Toronto Transit Commission (“TTC”) bus on June 22, 2015. The bus suddenly stopped and the applicant fell, hitting her right arm and shoulder on the floor of the bus. The applicant sustained a fracture to the ulna bone in her right forearm. There was no dispute that the applicant sustained injuries as a result of the accident and required medical treatment; the dispute is whether those injuries render her eligible for the requested benefits.
Motion to Dismiss - Raised by Respondent
7At the outset of the hearing, the respondent requested the applicant’s claim be dismissed due to non-compliance with certain requirements noted within the Schedule. I allowed the hearing to proceed to hear the merits of the case.
8The TTC submitted the following reasons to support its request to dismiss:
(i) Although it was requested by the TTC, the applicant did not provide the TTC with a Disability Certificate (also known as an “OCF-3 form”) within 10 business days as requested by the TTC, and therefore the applicant has not complied with section 33 (6) of the Schedule;
(ii) An Assessment of Attendant Care Needs Form (also known as a “Form 1”) was not submitted to the TTC until December 4, 2015. The respondent submitted, therefore, the applicant has not complied with the requirements of section 42 (5) of the Schedule;
(iii) The TTC submitted that the applicant did not provide basic requested medical records until one year and eleven months after they were requested by the TTC, and such records would have assisted the TTC in determining entitlement to claimed benefits. It is the TTC’s submission that the applicant has not complied with section 33 (6) of the Schedule;
(iv) The applicant has not provided proof that she has incurred the Attendant Care Benefit expense pursuant to sections 3 (7) (e) and 19 (1) - (3) of the Schedule.
9The respondent submitted that the applicant failed to provide an explanation of why she failed to comply with the above requirements. The respondent argued, alternatively, that if the applicant’s claim for attendant care benefits is not dismissed, it should be limited to the period from December 4, 2015 to January 10, 2016. The respondent suggested those dates because a Form 1 was not received until December 4, 2015 and the only expense claim form (“OCF-6”) received covered the period from June 22, 2015 to January 10, 2016.
10In response, the applicant argued that what was done by her previous legal counsel should have no bearing on this case.
11At the hearing, I ruled to allow the hearing to proceed to provide the applicant, who is self-represented, an opportunity to present her case to the Tribunal. I find that it would be procedurally unfair to deny the applicant the right to do so.
Request by Applicant to Admit Photographs and CD ROM
12At the hearing, the applicant requested that I view some photographs and that they be admitted into evidence. The applicant stated the photographs included her children who sustained injuries from the accident, pictures of her fenced yard where she planned to set up a home daycare, and pictures from inside the TTC bus. The respondent objected to the pictures being admitted as evidence at the hearing as some of the photographs had not been previously provided to the respondent. I did not allow the pictures to be admitted at the hearing because it would have been procedurally unfair to the respondent and the photographs were not directly relevant to the issues in dispute.
13The applicant also requested a copy of a CD ROM be admitted as evidence at the hearing. The applicant stated it contained video footage taken on the TTC bus at the time of the accident which showed the applicant falling on the TTC bus. The applicant stated the CD ROM was provided to her by the respondent on May 18, 2018. There was no request made by the applicant in advance of the hearing that the CD ROM was to be viewed.
14I ruled that the CD ROM would not be admitted as evidence for the hearing as I am to be determining entitlement to the non-earner benefit and the attendant care benefit. There was no dispute that the applicant sustained injuries as a result of the accident or that her current impairments were caused by the accident.
Is the Applicant Entitled to Receive a Non-earner Benefit?
The Law
15The test for entitlement to a non-earner benefit is set out within section 12 (1) of the Schedule. The insured person must prove that they suffer from a complete inability to carry on a normal life within 104 weeks of the accident. Section 7(b) of the Schedule states that a person suffers a complete inability to carry on a normal life as a result of an accident if, as a result of the accident, the person sustains an impairment that continuously prevents the person from engaging in substantially all of the activities in which the person ordinarily engaged before the accident.
16The Ontario Court of Appeal, in the 2009 decision of Heath v. Economical Mutual Insurance Company2, outlined several principles to be considered when determining an insured person’s entitlement to a non-earner benefit. I have utilized these principles to guide my analysis regarding the applicant’s entitlement to a non-earner benefit. These principles include:
(i) There must be a comparison of the applicant’s activities and life circumstances before the accident to those activities following the accident.
(ii) The applicant’s activities and life circumstances before the accident must be assessed over a reasonable period prior to the accident. The duration of which will depend on the facts of the case.
(iii) All of the applicant’s pre-accident activities must be considered, but greater weight may be placed on the activities which were of greater importance to the applicant’s pre-accident life.
(iv) The applicant must prove that his/her accident related injuries continuously prevented him/her from engaging is substantially all of his/her pre-accident activities. This means that the disability or incapacity must be uninterrupted.
(v) Even if an applicant can still perform an activity, if the applicant experiences significant restrictions when performing that activity, it may not count as “engaging in” that activity. Therefore, “engaging” should be interpreted from a qualitative perspective.
(vi) If pain is the primary reason which is preventing an applicant from engaging in their former activities, the question is whether the degree of pain practically prevents the applicant from performing those activities. The focus should not be on whether the applicant can physically perform those activities.
17Section 12 (4) (a) of the Schedule notes that the insurer is not required to pay a non-earner benefit to an insured person for the first 26 weeks after the onset of a complete inability to carry on a normal life.
ANALYSIS
18I find that the applicant is not entitled to a non-earner benefit for the reasons that follow.
19I find the applicant is still able to perform many of the activities she engaged in prior to the accident albeit with some pain and at a reduced frequency. The applicant produced medical evidence from an orthopedic surgeon which supports that the applicant’s fracture to the ulna bone in her right forearm has healed within the first 26 weeks of the accident. The applicant’s medical evidence does not adequately support that her right hand numbness was caused by the accident, or that the tendonitis in her right shoulder has been exacerbated by the accident. I find the applicant has not demonstrated on a balance of probabilities that the injuries she sustained from the accident have prevented her from engaging in substantially all of the activities which she participated in and enjoyed prior to the accident.
20The applicant testified she was a stay at home mother at the time of the accident and has two children who are currently twelve and seventeen years old. It is the applicant’s testimony that she engaged in the following activities prior to the accident:
(a) playing pool;
(b) taking her children to church;
(c) tutoring her son who was nine years old at the time of the accident;
(d) cooking meals every other day and baking once a week;
(e) going to the library three times per week to learn how to use a computer;
(f) household chores; and
(g) gardening.
21Following the accident, the applicant continues to reside at home with both of her children. The applicant testified that the following activities of daily living have changed for her since the accident:
(a) She has difficulty carrying groceries due to pain in her right shoulder and numbness in her right hand;
(b) She is able to carry out the garbage, groceries, clean the bathroom and vacuum but she does these things while experiencing pain;
(c) She stated she has been depressed from the accident;
(d) She further testified that she cooks every three days and bakes about once per month. She testified that her daughter sometimes assists with the cooking. She stated that she is no longer able to do her gardening and as a result, her roses are dying. She stated: “My house became like a jail for me. I am unable to do the things I used to”.
22The applicant attended and completed an Early Childhood Education course in February 2015. She testified that she made plans to open a home daycare in September 2015 but was unable to open the home daycare following the accident as a result of the injuries she sustained following the accident. Assuming that continuing efforts to open the business could be part of her “normal life”, other than the applicant’s oral testimony, the applicant has not provided any evidence which supports that she had taken the steps to open and operate a home daycare, such as a copy of an application for a licence. The applicant produced no documentation which supports she has any restrictions from being able to do the activities required to operate a home daycare from 26 weeks following the accident. The applicant has not produced evidence which supports that she could not continue to plan for the opening of a home daycare business, or any evidence to support that once a home daycare is opened, she has any restrictions relating to the required activities of its operation. Therefore, I am unable to conclude on a balance of probabilities that the applicant could not continue to plan for the opening of a home daycare if had not been but for the accident.
23The applicant also relies on two OCF-3’s in support of her claim for non-earner benefits. The first OCF-3, dated August 17, 2015, was completed by the applicant’s family doctor, Dr. J. Sugiyama. This form noted under part 6 that the applicant suffered a complete inability to carry on a normal life for more than 12 weeks and noted the following: “Extreme muscular atrophy in right upper extremity pain, weakness and decreased ROM”. Physiotherapy and chiropractic treatments were noted as contemplated or required under part 7 of the OCF-3. This OCF-3 was received by the respondent on September 28, 2015.
24The applicant provided a copy of a second OCF-3 dated December 3, 2015 which was completed by a chiropractor, Nick Simsiris, which noted the applicant suffered a complete inability to carry on a normal life for more than 12 weeks and noted this was due to the severity of her injuries noted below:
(a) Fracture of shaft of ulna, open
(b) Multiple injuries of shoulder and upper arm
(c) Multiple injuries of forearm
(d) Subluxation complex (vertebral), cervical region
(e) Rotator cuff syndrome
(f) Dislocation of wrist
(g) Multiple superficial injuries of wrist and hand
(h) Other sprain and strain of wrist
(i) Other Sprain and strain of elbow
(j) Low back pain
(k) Generalized anxiety order
(l) Irritability and anger
(m) Post-traumatic stress disorder
25This OCF-3 had a fax confirmation which notes it was sent to the respondent on December 3, 2015. The waiting period for entitlement to the non-earner benefit is 26 weeks. The two OCF 3’s dated September 28 and December 3, 2015 were both submitted prior to the 26 week eligibility period. Neither Dr. Sugiyama, nor Nick Simsiris were produced as witnesses for the hearing. No further evidence was produced by the applicant to support how they had reached their conclusion that the applicant suffered a complete inability to carry on a normal life for more than 12 weeks. There were no reports produced from either doctor so it is unclear if these doctors performed any assessments on the applicant to assess the non-earner benefit. The OCF-3’s list the physical impairments the applicant sustained but there has been nothing further provided by either author of these OCF-3s which addresses how these impairments impact the applicant’s activities of daily living and what activities she is unable to perform. In the second OCF-3 dated December 3, 2015, the chiropractor, Nick Simsiris noted psychological impairments were sustained by the applicant. This is outside of his scope of specialization. The applicant has not produced evidence which supports she sustained a psychological impairment resulting in the applicant having a complete inability to carry on a normal life. Therefore, I afford little weight to the conclusions noted within the OCF 3s that the applicant suffers a complete inability to carry on a normal life for more than 12 weeks.
26The CNRs of Dr. Sugiyama were provided up to February 2016 and note the applicant saw Dr. Sugiyama for accident related issues on the dates of: June 23, 2015, July 9, 2015, August 10, 2015, and August 20, 2015. The CNRs noted pain in her right arm and scaly dermatitis (dry skin), and no numbness. There was nothing noted within Dr. Sugiyama’s records which referenced reports of depression or a similar condition. The applicant has not seen a doctor for depression and has not been diagnosed with depression. There is no medication which the applicant has been prescribed for depression. It is the applicant’s testimony that she did not seek assistance from a medical professional regarding the depression but she conceded it was her responsibility to do so.
27Accordingly, I do not find the applicant has provided evidence that establishes on a balance of probabilities that she suffers from depression as a result of the accident and that it has caused a complete inability for the applicant to substantially engage in all of her pre-accident activities. There has been no medical diagnosis of depression. In the absence of any psychological/psychiatric diagnosis, or any corroborating evidence beyond the oral testimony provided at the hearing from the applicant and the attendant care service provider, I do not find the applicant suffered a psychological impairment as a result of the accident.
28The applicant saw Dr. M. Roscoe, an orthopedic surgeon, for her right arm fracture and for her right shoulder pain. An x-ray report dated June 20, 2015 of the applicant’s right shoulder noted “calcific tendinitis of the rotator cuff”. The consultation note from Dr. Roscoe dated June 30, 2015 noted “calcific tendinitis, longstanding in nature”. This evidence supports that the tendonitis in the applicant’s right shoulder existed prior to the accident and is therefore not a result of the accident. The applicant has not produced any medical evidence which supports that the accident has exacerbated her right shoulder impairment.
29A further consultation note of Dr. Roscoe dated October 27, 2015 noted the applicant’s right ulna “is completely healed clinically and radiologically” and “x-rays show a solidly united ulna”. Dr. Roscoe further noted the applicant has symptoms of “RSD” (Reflex Sympathetic Dystrophy) and recommended continued physiotherapy and rehabilitation. This evidence supports that the applicant’s fracture had completely healed by October 27, 2015.
30The applicant attended physiotherapy for 18 months following the accident which was funded by the respondent. The last time she attended physiotherapy was around June/July 2017. This was the only treatment she received following the accident. The applicant confirmed she did not request any further physical rehabilitation treatment from the respondent and acknowledged the respondent did not deny any treatment plans for physical rehabilitation treatment.
31Dr. G. Yee, orthopedic surgeon, testified as an expert witness. Dr. Yee conducted an insurer’s examination (“IE”) on the applicant on February 3, 2016 and issued a report on February 16, 2016. The respondent asked Dr. Yee to explain his findings from his examination of the applicant. Dr. Yee stated that at the time he assessed the applicant she was wearing a right wrist splint and there was evidence of some functional limitations on her right side with regards to bending and lifting. Dr. Yee noted within his report that the applicant was independent with her personal care tasks but received assistance from a personal support worker (“PSW”) four hours per day for housekeeping and home maintenance chores.
32In response to the question: “Does the insured suffer a complete inability to carry on a normal life as a result of the accident?” Dr. Yee stated that at the time of the assessment there was evidence of residual impairment but it was not substantial enough to constitute a complete inability to carry on a normal life as a direct result of injuries sustained in the accident.
33The applicant disagreed with Dr. Yee’s conclusion and stated that she saw a specialist at Sunnybrook hospital in March 2017 who she was referred to by Dr. Sugiyama. However, she did not produce a copy of the report from the specialist she saw at Sunnybrook hospital, or a copy of the referral letter issued by Dr. Sugiyama. The applicant also stated that she was not independent with her personal care tasks at the time of Dr. Yee’s assessment as she still required assistance with fastening her bra. I am persuaded by Dr. Yee’s conclusion in his report, which concluded that the applicant had some functional limitations at the time of the assessment but it did not constitute a complete inability to carry on a normal life as a direct result of injuries sustained in the accident. As noted above, Dr. Yee reached his opinion following an interview and physical assessment of the applicant. There has been no medical evidence produced by the applicant to challenge the conclusion reached by Dr. Yee.
34The applicant stated she requested updated CNRs from Dr. Sugiyama but was only provided with an updated letter dated May 22, 2018. The letter noted that the applicant sustained a right ulna fracture and right rotator cuff strain as a result of the accident. The letter further noted the applicant has “residual right arm and wrist pain and numbness in her fourth and fifth digits, suggestive of an ulnar nerve injury”. Dr. Sugiyama further noted: “Given her history of trauma to her ulna, it is likely that this is due to her initial injury”. Dr. Sugiyama noted he is arranging for an EMG to investigate her right hand numbness. To date there has been no medical evidence produced by the applicant which diagnoses the cause of the numbness in her right hand. I do not find that the applicant has met her onus and proven on a balance of probabilities that the numbness in her right hand is a result of the accident.
SURVEILLANCE
35The respondent produced surveillance video evidence which was shown at the hearing. The surveillance took place on four dates in 2016 - January 5, June 27, June 28, and July 10. The surveillance showed the applicant doing the following activities:
(a) carrying out bags of garbage from her house using both of her hands;
(b) jogging a short distance with her son to the school bus stop;
(c) walking with her daughter and carrying her purse in her right hand while nothing was in her left hand;
(d) folding laundry blankets;
(e) talking on the phone for two hours while bending/crouching on her front porch.
36I find the surveillance evidence generally supports the respondent’s position that the applicant does not suffer from a functional impairment which would significantly impact her activities of daily living. The surveillance evidence showed the applicant continuing to perform some of her activities of daily living outside of the house without any apparent difficulty. There was no surveillance taken of the inside of the applicant’s home. After reviewing the surveillance evidence taken outside the house, I am not persuaded that the applicant would be unable to perform her household tasks such as cooking, cleaning, and personal care.
37The applicant testified that she was a stay at home mother prior to and following the accident. She has stated that since the accident she has been unable to do her gardening. The applicant stated she continues to perform many of her pre-accident activities at a reduced frequency and with pain. These activities include: cooking, sweeping, vacuuming, cleaning the bathroom, cooking, and taking out the garbage. The inability to engage in activities post-accident which were previously engaged in prior to the accident is not determinative of entitlement to the non-earner benefit. The test for the non-earner benefit requires that an applicant must prove that he/she is unable to engage in substantially all of her pre-accident activities, with emphasis on the most important ones. Other than the applicant testifying that she has been unable to do her gardening since the accident, the applicant continues to engage in the majority of her pre-accident activities. The applicant has reported experiencing pain but the evidence above supports that she continues to engage in these activities.
38In summary, the evidence before me regarding the applicant’s pre and post-accident activities and her life circumstances were provided through the applicant’s testimony. I find there has not been enough evidence before me to conclude that the injuries sustained by the applicant as a result of the accident have prevented her from engaging in substantially all of her pre-accident activities. The onus is on the applicant to demonstrate on a balance of probabilities that as a result of the accident she is unable to engage in substantially all of her pre-accident activities which she enjoyed prior to the accident. I find the applicant has not met this burden of proof, and as a result, I do not find that the applicant suffers from a complete inability to carry on a normal life as a result of the accident.
Is the Applicant Entitled to Receive an Attendant Care Benefit?
The Law
39Section 19 (1) (a) of the Schedule provides that an insurer shall pay attendant care benefits for reasonable and necessary expenses for services provided by an aide or attendant, or a long-term care facility as a result of the accident which are incurred by, or on behalf of, an insured person. Thus, an applicant claiming an attendant care benefit must establish it is reasonable and necessary, and that the expense was “incurred”.
40Section 3 (7) (e) of the Schedule defines “incurred”. The section provides that (1) the insured person needs to have received the goods or services related to the expense, (2) The insured person has to have paid the expense, or promised to pay the expense, and (3) the person who provided the attendant care service(s) must have done so in the course of their employment, occupation, or profession, normally engaged in, but for the accident, or sustained an economic loss as a result of providing the good and services to the insured person.
41Further, section 42 (5) of the Schedule notes that an insurer is not required to pay an expense for attendant care needs which is incurred prior to an assessment of attendant care needs (“Form 1”) is submitted to the insurer.
ANALYSIS
42As applicable to this matter, I find it reasonable that the applicant would likely have required some assistance with her attendant care needs, at least for the period in which her right arm was initially casted, representing the period from June 22, 2015 until August 11, 2015. August 11 is the date, according to Dr. Sugiyama’s CNRs, that her cast was removed. However, no attendant care is payable during this period as per section 42 (5) of the Schedule as the applicant did not submit a Form 1 to the TTC until December 4, 2015. Therefore, no attendant care is payable prior to this date as the Form 1 was not received by the TTC.
43Likewise, on a balance of probabilities, I do not find that the evidence establishes that the applicant required assistance with her attendant care needs beyond December 4, 2015 for the reasons I note further below.
44The following evidence was relied on by the applicant in support of her claim for entitlement to the attendant care benefit.
45The applicant stated that she received attendant care from June 25, 2015 to the end of June 2016 which was provided by Felicia De Raveniere (“Ms. De Raveniere”), a personal support worker (“PSW”). The applicant stated Ms. De Raveniere assisted her four hours per day, four times per week at a rate of $20.00 per hour. The certificate showing Ms. De Raveniere was certified as a PSW was provided to the respondent on February 9, 2017. The applicant stated Ms. De Raveniere assisted with the following duties: bathing, cooking, cleaning the bathroom, vacuuming, making sandwiches, and changing the linens on the bed.
46The applicant stated that a friend of hers, [D.G.] would occasionally bring her food and pick up her prescriptions.
47The applicant did not have any receipts for the attendant care which she had received and the applicant stated she had never paid, or promised to pay, Ms. De Raveniere, nor [D.G.], for any attendant care services.
48Although the applicant stopped receiving attending care services around the end of June 2016, a Form 1 dated October 8, 2015 was completed by Joanne Romas, Occupational Therapist (“O.T.”) but was not faxed to the respondent until December 4, 2015. The Form 1 noted the applicant required attendant care services in the amount of $2,724.10 per month. The applicant did not provide a reason why the Form 1 had not been sent to the TTC prior to this date.
49Ms. De Raveniere testified that she provided attendant care services to the applicant from June 2015 to June 2016 four times per week for four hours per day at the rate of $20.00 per hour. Ms. De Raveniere stated the applicant was not able to do things following the accident as her right arm was in a cast and she was also depressed. The services provided by Ms. De Raveniere included: assisting the applicant with turning the knob for the water in the shower, and soaping the applicant in the shower, cooking meals to last for a few days, laundry, assisting the applicant and the applicant’s son with showering and hair braiding, vacuuming, and changing the linens on the bed.
50Ms. De Raveniere stated that she was told by the applicant when her lawyer settles her case, Ms. De Raveniere would then be paid for her services but stated to date she has not been paid any money for the attendant care she provided.
51I find the applicant is not entitled to the attendant care benefit for the following reasons:
(i) The insurer is not required to pay an attendant care benefit prior to receiving a copy of a Form 1. The applicant testified she received attendant care from June 25, 2015 to the end of June 2016. Ms. De Raveniere stated that she assisted the applicant following the accident because her right arm was in a cast and she was depressed. Evidence provided at the hearing confirmed the TTC did not receive a copy of the Form 1 prior to December 4, 2015 and no explanation was provided by the applicant as to why one had not been provided prior to this date. Therefore, pursuant to s. 42 (5) of Schedule, the applicant would not be entitled to receive attendant care benefits prior to December 4, 2015.
(ii) There have been no CNRs of Dr. Sugiyama provided for the period August 20, 2015 - February 4, 2016. The evidence from the consultation note of Dr. Roscoe dated October 27, 2015 noted the fracture had healed. Dr. Yee’s report of February 16, 2016 noted the applicant was independent with her personal care tasks. The applicant stated she still required assistance with fastening her bra at that time and therefore was not independent with her personal care tasks. I prefer the evidence of Dr. Yee’s report over the applicant’s testimony and the testimony of Ms. De Raveniere as no further objective medical evidence was produced by the applicant to corroborate she required assistance with her personal care after her cast was removed. The surveillance evidence viewed at the hearing from the date of January 5, 2016 onward generally supported the applicant did not have any functional impairments relating to performing her activities of daily living and utilizing both of her hands.
(iii) The applicant and Ms. De Raveniere testified that the applicant received assistance with laundry, vacuuming, changing the bed linens, and cleaning the bathroom. These services are housekeeping services and I cannot consider payment for them under attendant care needs.
(iv) The applicant is not entitled to receive attendant care benefits prior to December 4, 2015, as this is the date the Form 1 was received by the respondent. The evidence produced at the hearing does not support that the applicant required assistance with her attendant care needs beyond this date. I therefore find no attendant care benefits to be payable for the reasons outlined above.
INTEREST
52As no benefits are found to be payable, no interest is payable.
CONCLUSION
53The applicant is not entitled to receive a non-earner benefit for $185.00 per week from January 21, 2016 to date and ongoing.
54The applicant is not entitled to an attendant care benefit for $3,000.00 per month from June 22, 2015 to June 21, 2017.
55As no benefits are payable, no interest is payable.
Released: September 19, 2018
_________________________
Kimberly Parish, Adjudicator
Footnotes
- O. Reg. 34/10.
- Heath v. Economical Mutual Insurance Company, 2009 ONCA 391, 2009 CarswellOnt 2443