The claimant sought entitlement to ACBs and various medical benefits for occupational therapy services, assistive devices, and chiropractic services. Adjudicator Paluch rejected the claim for ACBs and most of the medical benefits, but allowed the claims for assistive devices and one of the occupational therapy services. Regarding the ACBs claim, the claimant failed to prove that any services were incurred. The claimant’s affidavit submitted in support of the claim was vague and unhelpful as it did not provide specific details of services, times, duration, level of care, and no exhibits were provided from care providers detailing this information either. Adjudicator Paluch also questioned how the claimant could require 10 hours of supervisory care when the medical evidence was clear that the claimant could respond to an emergency independently. The adjudicator declined to deem the expenses incurred under section 3(8) as the claimant failed to advance any arguments, analysis, or evidence how the insurer unreasonably withheld or delayed payment, other than stating in a general way that the benefits were wrongfully denied. Adjudicator Paluch awarded the claim for a new mattress because there was evidence that the claimant had poor sleep as a result of her injuries and the new mattress did provide improved sleep. A portion of claimed occupational therapy sessions were also awarded because the insurer’s denial did not comply with section 38(8) (no medical reason was provided as to why the proposed treatment was “quite excessive”). Adjudicator Paluch was critical of the claimant’s failure to provide documentation as ordered in the Case Conference Order. Claimant’s counsel insisted on payment for records before production of same, despite the Order not requiring the insurer to pay for the records. Once the records were in the claimant’s possession, she should have provided them. Her failure to do so prevented the Tribunal from having the ability to review the complete clinical notes and records.
