The claimant sought entitlement to attendant care benefits provided by her husband (a fertility physician) and the cost of an in-home assessment. The insurer denied that the claimant had “incurred” any attendant care services and further denied that any attendant care services were reasonable and necessary beyond June 2016. The claimant responded that the insurer was estopped from denying payment of attendant care benefits because it had already accepted that services had been “incurred” in earlier months by services provided by her husband. Adjudicator Paluch considered all three elements of the “incurred” definition and concluded that none of the requirements had been met. First, he held that claimant had not proven on a balance of probabilities that her husband had provided the services claimed, and that the expense forms were not an accurate reflection of services that were actually provided. Second, he held that the claimant did not have any legal obligation to pay her husband for any services he may have provided. Third, he held that the claimant’s husband was not a professional service provider (his regular employment did not concern any tasks that were contained in a Form 1), and that the service provider had not proven that an economic loss had been sustained by providing services to the claimant. In particular, Adjudicator Paluch was critical of the service provider not providing any records of lost income or time from work, and instead simply providing oral testimony. Finally, Adjudicator Paluch concluded that the LAT did not have jurisdiction to administer the rules of equity, as it could only grant remedies set out in its enabling statute. Adjudicator Baluch denied the claim for attendant care benefits and the in-home assessment cost.
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