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K.K. v. Aviva Insurance Canada (19-001300)

  • November 2, 2020

The self-represented claimant sought IRBs, medical benefits, interest, and a special award. Adjudicator Lake dismissed the claims. With respect to the claim for IRBs, Adjudicator Lake found that the insurer’s surveillance was persuasive as it showed the claimant working at a construction site completing various physical tasks, including carrying two cinderblocks. Adjudicator Lake also noted that the claimant’s evidence was inconsistent with respect to when he returned to work and the claimant did not submit any evidence of his post-accident work status, income, or pay stubs. Adjudicator Lake noted that when she attempted to ask the claimant about his post-accident earnings, he provided vague answers. With respect to medical benefits, Adjudicator Lake relied on the records of the claimant’s general practitioner and the IE report to conclude that the proposed treatment plans were not reasonable or necessary. In particular, Adjudicator Lake noted that at no time did the claimant general practitioner recommend chiropractic treatment.

Full decision here

TGP Analysis

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  • FILED UNDER Income Replacement Benefits, Medical Benefits
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