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T.P. v. Wawanesa Insurance Company (18-003718)

  • December 16, 2020

The claimant sought entitlement to IRBs. Adjudicator Boyce found that the claimant was not entitled to payment of IRBs as he did not demonstrate that he met the substantial inability test. While the adjudicator accepted that the claimant was not working during the period in dispute, the claimant failed to provide any objective medical evidence to support that he was not working as a result of his accident-related pain or that his accident-related pain was preventing him from engaging in his essential pre-accident tasks. It is not enough for the claimant to simply state that he could not do something; there needed to be objective evidence of that inability. The adjudicator suggested that it should come in the form of an objective medical opinion or diagnostic imaging or an occupational therapy report that would contemporaneously support the claimant’s subjective reporting.

Full decision here

TGP Analysis

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