Mary Henein Thorn

The applicant was involved in a motor vehicle accident and sought post-104 week income replacement benefits (IRBs) and interest.

The respondent denied the benefits, arguing the applicant could maintain employment.

The Tribunal found the applicant suffered a concussion and mild traumatic brain injury, leading to significant physical and psychological impairments.

Preferring the evidence of the applicant's experts over the respondent's, the Tribunal concluded the applicant demonstrated a complete inability to engage in any employment for which she is reasonably suited by education, training, or experience.

The applicant was awarded IRBs of $168.59 per week from August 24, 2023, to date, plus interest.

The applicant sought statutory accident benefits following a motor vehicle accident, including post-104 income replacement benefits (IRB), medical benefits, and a special award.

The Tribunal found the applicant did not meet the test for post-104 IRB, as she failed to prove a complete inability to engage in any employment for which she was reasonably suited.

The Tribunal preferred the evidence of the respondent's assessors, noting inconsistencies in the applicant's reporting and her failure to complete several assessments.

The claims for medical benefits, assessments, and a special award were also dismissed.

The applicant was injured in a motorcycle accident and sought a determination that he sustained a catastrophic impairment under criterion 8 of the Statutory Accident Benefits Schedule due to mental and behavioural disorders.

The respondent denied the claim, arguing the applicant's impairments were moderate and stemmed from pre-existing conditions.

The Tribunal preferred the evidence of the applicant's assessors, finding that the applicant suffered marked impairments in the spheres of activities of daily living, social functioning, concentration, persistence and pace, and adaptation.

The Tribunal concluded the applicant is catastrophically impaired.

The applicant was injured in a severe motor vehicle accident and sought a determination that she sustained a catastrophic impairment under criterion 7 of the Statutory Accident Benefits Schedule.

The applicant claimed a combined whole person impairment (WPI) of 55%, relying on various physical and psychological assessments.

The respondent argued the WPI was 35%.

The Tribunal evaluated the competing expert medical evidence regarding the applicant's spinal impairments, scarring, headaches, vertigo, and psychological functioning.

Ultimately, the Tribunal preferred the respondent's experts on several key issues, concluding that the applicant's combined WPI was 50%.

As this fell short of the 55% threshold, the application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming catastrophic impairment under criteria 7 and 8, attendant care benefits, and physiotherapy services.

The Tribunal found the applicant was not catastrophically impaired, preferring the respondent's medical assessors and surveillance evidence which demonstrated the applicant maintained an active lifestyle and had significant pre-existing psychiatric conditions that were not properly accounted for by his own assessors.

The Tribunal also dismissed the claims for attendant care and physiotherapy, finding the applicant was capable of managing his daily activities independently and had reached maximum therapeutic benefit from prior treatments.

The applicant sought a non-earner benefit (NEB), an award for unreasonable delay, interest, and costs following a motor vehicle accident.

The respondent denied the NEB, arguing the applicant's impairments were pre-existing and temporary.

The Tribunal found that the accident exacerbated the applicant's pre-existing physical and psychological conditions, resulting in a complete inability to carry on a normal life.

The applicant was awarded the NEB and interest.

However, the Tribunal dismissed the claims for a special award and costs, finding the respondent did not act unreasonably, frivolously, or in bad faith.

The applicant was injured in a motor vehicle accident and sought income replacement benefits (IRBs).

The respondent deemed the applicant eligible for IRBs but failed to pay them for nearly two years, ignoring multiple inquiries from the applicant.

The Licence Appeal Tribunal found that the respondent's failure to pay the benefits, despite having the necessary documentation and an accountant's report supporting entitlement, constituted an unreasonable delay.

The Tribunal ordered the respondent to pay a special award under s. 10 of Regulation 664 equal to 50% of the IRBs claimed during the period of delay, plus interest.

The applicant sought various statutory accident benefits following a motor vehicle accident, including attendant care benefits, assistive devices, medical cannabis, and a psychovocational assessment.

The Tribunal denied the attendant care benefits because the applicant failed to prove the expenses were incurred after she dismissed her personal support worker.

Claims for a new mattress and medical cannabis were also dismissed for lack of medical evidence establishing them as reasonable and necessary.

However, the Tribunal granted the request for a psychovocational assessment, finding that the respondent's assessors had not adequately evaluated the applicant's ability to perform the heavy physical and mental demands of her pre-accident employment as a personal support worker.

The Tribunal also approved a prescription for Metformin, accepting that the applicant's accident-related inactivity exacerbated her pre-existing diabetes.

The claim for a special award was dismissed.

The applicant sought a determination of catastrophic impairment (Criterion 8) due to a mental or behavioural disorder following a motor vehicle accident, along with payment for prescriptions and interest.

The Tribunal found that the applicant did not suffer a marked impairment in the spheres of activities of daily living, social functioning, or adaptation, noting that the applicant's expert failed to adequately account for pre-existing physical and psychological conditions.

The Tribunal preferred the respondent's experts, concluding the applicant suffered at most moderate impairments.

The claims for prescriptions and interest were also dismissed.

The applicant was involved in a motor vehicle accident and sought various statutory accident benefits, including income replacement benefits (IRBs), attendant care services, and medical/rehabilitation benefits.

The respondent insurer denied the benefits.

The Licence Appeal Tribunal found that the applicant failed to meet his burden of proving entitlement to any of the claimed benefits.

Specifically, the applicant did not provide compelling medical evidence to establish a substantial or complete inability to perform the essential tasks of his pre-accident employment.

The Tribunal also dismissed the claims for attendant care and treatment plans due to a lack of supporting evidence.

The respondent's request for costs was denied, as the applicant's conduct was not found to be unreasonable, frivolous, vexatious, or in bad faith.

The application was dismissed in its entirety.

The applicant sought statutory accident benefits, including income replacement benefits, attendant care benefits, and a treatment plan for psychological services following a motor vehicle accident.

The applicant was represented by his spouse and failed to provide any medical documentation or expert testimony to support his claims.

The adjudicator relied on the respondent's section 44 assessment reports and surveillance evidence, which contradicted the applicant's claimed impairments and demonstrated his ability to perform daily activities independently.

The application was dismissed in its entirety.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including non-earner benefits and various treatment plans.

The respondent denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that the applicant failed to provide sufficient objective medical evidence to prove that she suffered from chronic pain or psychological impairments warranting removal from the MIG.

The Tribunal also dismissed the claim for non-earner benefits, finding that the applicant continued to work and engage in her pre-accident activities, and therefore did not suffer a complete inability to carry on a normal life.

The application was dismissed in its entirety.

The applicant sought a determination that she sustained a catastrophic impairment under Criterion 8 of the Statutory Accident Benefits Schedule following a motor vehicle accident.

The applicant claimed marked impairments in social functioning, concentration, persistence and pace, and adaptation due to psychological issues including depression and anxiety.

The Tribunal preferred the evidence of the respondent's assessors, finding that the applicant's impairments were moderate (Class 3) rather than marked (Class 4).

The Tribunal noted the applicant's ability to maintain relationships, travel, manage her children's schedules, and handle personal affairs, concluding she did not meet the threshold for catastrophic impairment.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit and costs for psychological assessments and services.

The Licence Appeal Tribunal found that the applicant did not meet the test for a non-earner benefit, as he failed to demonstrate a complete inability to carry on a normal life.

However, the Tribunal granted the costs for the psychological assessment and services, finding that the additional hours billed for interpretation services and planning due to the applicant's language barrier were reasonable and necessary.

The applicant's claim for a special award under section 10 of Regulation 664 was dismissed, as the insurer's conduct was not found to be unreasonable.

The applicant requested a reconsideration of a previous Tribunal decision which found she was not catastrophically impaired.

The applicant argued the Tribunal breached procedural fairness by limiting her testimony time and erred in law by misinterpreting Criterion 8 and allowing an expert to testify outside the scope of his report.

The Tribunal dismissed the request, finding no breach of procedural fairness as the hearing was managed efficiently under the Statutory Powers Procedure Act.

The Tribunal also found no errors of law or fact that would have changed the outcome, noting the applicant was attempting to re-litigate the weight assigned to the evidence.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that denied her claims for home modifications to her daughter's home under the Statutory Accident Benefits Schedule.

The applicant argued the Tribunal breached procedural fairness by excluding her Personal Support Worker from testifying and by misapplying the evidentiary burden regarding a section 44 assessment.

She also argued the Tribunal erred in law by not interpreting 'existing home' to include her daughter's home.

The Tribunal dismissed the reconsideration request, finding no breach of procedural fairness in excluding a late-identified witness and concluding that the applicant failed to provide sufficient evidence that her current residence could not be modified.

The applicant sought various statutory accident benefits, including treatment plans and attendant care benefits, following a motor vehicle accident.

At the start of the videoconference hearing, both parties requested to convert the proceeding to a written hearing as they were unprepared to proceed.

The adjudicator denied the request, noting the file's age and proper notice, and ordered a brief recess for preparation.

Following the recess, the parties advised that they had settled all issues in dispute, resulting in the closure of the Tribunal's file.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and that the MIG limits were exhausted.

The applicant argued her psychological injuries and chronic pain warranted removal from the MIG, and sought non-earner benefits and treatment plans.

The Tribunal found the medical evidence did not support the applicant's claims of chronic pain or psychological impairment, noting her symptoms resolved shortly after the accident.

The Tribunal also found the applicant maintained a substantial amount of her pre-accident activities and did not meet the test for non-earner benefits.

The application was dismissed.

The applicant sought statutory accident benefits following two motor vehicle accidents in 2013 and 2014, claiming he sustained a catastrophic impairment due to mental and behavioural disorders.

The Licence Appeal Tribunal dismissed the application, finding that the applicant failed to prove a marked or extreme impairment in any of the four functional domains.

The Tribunal preferred the evidence of the respondent's experts, noting that the applicant's experts failed to adequately consider his extensive pre-existing medical and psychiatric conditions, including chronic pain, depression, and strokes.

The Tribunal also found that the disputed treatment plans for a functional ability evaluation and an attendant care assessment were not reasonable and necessary, as the applicant's ongoing impairments were primarily attributable to the progression of his pre-accident conditions.

Claims for an award and interest were consequently dismissed.

The applicant sought a determination that she sustained a catastrophic impairment under criterion 8 of the SABS following a motor vehicle accident.

The dispute centered on whether she had marked impairments in Activities of Daily Living and Concentration, Persistence, and Pace.

The Tribunal found that while the applicant suffered moderate impairments, she retained significant useful functioning, such as driving, caring for her autistic son, and attending the gym regularly.

The Tribunal concluded the applicant did not suffer a catastrophic impairment and dismissed the claims for an award and interest.