The claimant sought a determination that he suffered a catastrophic impairment due to a 2014 accident. He had already been found to suffer a catastrophic impairment from a 2011 accident. The insurer argued that the 2014 accident did not cause an exacerbation of the claimant’s impairments, and argued that the claimant was not credible. Vice Chair Flude found that the claimant suffered a catastrophic impairment from the 2014 accident due to Class 4 Marked Impairments in social functioning; concentration, persistence, and pace; and deterioration or decompensation in work or work-like settings. Vice Chair Flude acknowledged that the claimant appeared to be tailoring evidence as a deliberate attempt to frustrate the insurer’s psychological assessor. Nevertheless, there was additional evidence that supported the claimant’s position. The claimant’s experts explained that the claimant had a severe deterioration in function after the 2014 accident, even though he was suffering impairments from the earlier accident. The claimant spent a large part of his day in bed and rarely interacted with his spouse or children. He gave up on attempting to find employment because he was overwhelmed by his mental health issues. Vice Chair Flude also addressed the insurer’s causation argument, holding that the 2014 accident was a necessary cause of the claimant’s decline in mental health.
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