The claimant sought catastrophic determination as a result of his accident-related injuries, and underwent assessments in preparing his OCF-19. After receiving the claimant’s CAT Application, the insurer requested that the claimant attend various IEs in order to assess him for CAT. The claimant refused to attend the neuropsychological IE, arguing that it was not reasonably necessary to determine CAT. The insurer raised a preliminary issue to determine whether the claimant was barred from proceeding with his CAT Application, and further raised a second preliminary issue to determine whether the claimant is barred from proceeding with the remaining issues in his application (medical benefits and IRBs) as he disputed these denials past the two year limitation period. Adjudicator Boyce held that the claimant was barred from proceeding with his CAT Application until he attends the neuropsychological IE, finding that there was a reasonable connection between the requested IE and the alleged impairments given the claimant’s reported headaches and post-concussion syndrome. He further held that the claimant was barred from proceeding with the remaining issues in dispute, as he failed to appeal the insurer’s denials within the limitation period. Notably, Adjudicator Boyce declined to apply the decision in Tomec, finding that the discoverability rule did not apply to IRBs and that an insured’s loss is crystallized upon receipt of a notice of termination, and further declined to apply section 7 of the LAT Act to extend the limitation period.
