C.J. v. Aviva Insurance Canada (18-007905)

The claimant sought entitlement to NEBs. The claimant submitted that virtually all her activities of daily living were affected by the accident. She was unable to perform her self care, cultural homemaking activities, socialize, or go to the gym, causing her weight gain and affecting her ability to have a child – all contributing to the break-down of her marriage. A month after the accident, the claimant’s niece moved in with her and would do the cooking, cleaning, bathing and grooming. The claimant submitted that physiotherapy did not help much and her anxiety remained “through the roof”. However, the claimant did not submit any expert medical evidence, or even a family doctor’s letter or disability note, that supported her claim. The medical evidence from her family doctor only contained a few entries mentioning the index accident and those attendances contradicted the claimant’s statement during her IE. The only medical evidence that meaningfully supported the claimant was the psychological IE, which diagnosed her with an “Adjustment Disorder with mixed anxiety and depressed mood; specific phobias, vehicular” but the doctor opined that she did not suffer a complete inability to carry on a normal life. The other IE reports also found that the claimant did not suffer impairments that would prevent her from conducting her daily activities. Adjudicator Shapiro accepted the IE reports as they were unchallenged by conflicting medical reports or records, appeared logical on their surface, and consistent with other evidence. The insurer further argued that the evidence the claimant did present was not reliable as she had provided many different accounts of many different accident related and life events. Adjudicator Shapiro agreed with the insurer as the volume of inconsistent information in the record was striking and extensive, across many different subjects. In conclusion, Adjudicator Shapiro found that the claimant’s testimony was not reliable, and when considered against all of the inconsistences, lack of medical support, and missing evidence, Adjudicator Shapiro had strong doubts that the claimant suffered a complete inability to carry on a normal life and she was not entitled to NEBs.