The claimant sought entitlement to attendant care benefits and housekeeping expenses after a catastrophic impairment application. The insurer argued that those benefits had been denied more than two years prior, and were therefore statute barred. Adjudicator Johal agreed with the insurer. He held that the denials of HK expenses and ACBs were clear and unequivocal despite referencing the wrong section numbers of the SABS. He also held that payment of past ACBs and HK expenses which were made in error after the catastrophic impairment determination did not negate the initial denial (the LAT application was made more than two years after the insurer notified the claimant of the error). Adjudicator Johal also noted that post-104 week HK expenses and ACBs were not new benefits, and that the denial of those benefits before the 104 week mark applied equally to those benefits after the 104 week mark. Finally, the adjudicator held that the catastrophic impairment determination did not support a “discoverability” argument that restarted the limitation period.
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