The claimant sought entitlement to IRBs, medical/rehabilitation benefits, a psychological assessment, and the cost of an accountant’s report. The respondent denied the claims for medical and rehabilitation benefits because it determined that the claimant’s injuries fell within the MIG. Adjudicator Neilson accepted that the claimant sustained a psychological impairment as a result of the accident that removed him from the MIG. He was therefore entitled to the medical/rehabilitation benefits and psychological assessment sought. With respect to IRBs, Adjudicator Neilson held that the claimant was entitled to IRBs from February 8, 2021 (date of submission of OCF-3) to March 3, 2021 (date of return to work). The claimant was not entitled to IRBs before the OCF-3 was submitted to the respondent on February 8, 2021. Adjudicator Neilson emphasized that the date on which the OCF-3 was prepared was not a consideration. She went on to note that those consequences did not apply prior to submission of an OCF-10 election form, as the SABS do not state that a specified benefit is not payable for any period before the OCF-10 is submitted (unless the OCF-10 was requested under section 33 of the SABS, it was not submitted on time, and the claimant had no reasonable excuse for delay). She also noted that there was no requirement in the SABS for an insurer to mention section 33 when making a request for information or to advise an insured person of the consequences for failing to comply with a section 33 request. The claimant was entitled to the cost of an accountant’s report under section 7(4) of the SABS because his IRB entitlement was not a straightforward simple calculation as he was self-employed at the time of the accident. Accordingly, an accounting report calculating the claimant’s base amount for the purpose of calculating IRBs was necessary.
