Dr. Cherisse McKay

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

The respondent denied several treatment plans for occupational therapy, social rehabilitation counselling, rehabilitation therapy, and psychological services.

The Tribunal found the applicant entitled to the outstanding balance for occupational therapy and the full amount for rehabilitation therapy, as medical evidence supported their necessity for addressing cognitive and functional impairments.

However, the Tribunal denied the plans for social rehabilitation counselling and psychological services due to insufficient evidence, duplication, and non-compliance with the Professional Services Guideline.

Claims for a section 10 award and costs were also dismissed.

The applicant sought resolution of a dispute over statutory accident benefits following a motor vehicle accident.

The issues included whether the insurer was required to pay income replacement benefits directly to the applicant, entitlement to the balance of a neuropsychological assessment, and a claim for a special award for unreasonable delay.

The Tribunal found that the insurer unreasonably delayed payment by unilaterally deciding to send the income replacement benefits to the applicant's representative rather than the applicant directly, without a court finding of incapacity.

The Tribunal awarded 20% of the value of the payments sent to the representative.

However, the Tribunal denied the remaining cost of the neuropsychological assessment, finding it constituted a single assessment subject to the $2,000 limit under the Schedule.

The applicant was injured in a pedestrian knockdown accident and sought statutory accident benefits.

The respondent paid income replacement benefits (IRBs) initially but later terminated them after the applicant failed to attend multiple insurer's examinations (IEs).

The applicant eventually attended a psychiatric IE, after which the respondent reinstated IRBs and accepted she was catastrophically impaired, but refused to pay IRBs for the period of non-attendance.

The applicant sought payment of the withheld IRBs and a special award under s. 10 of Reg. 664, alleging the respondent unreasonably delayed payment, failed to accommodate her disabilities under the Human Rights Code, and improperly scheduled the IEs.

The Tribunal dismissed the application, finding the respondent provided proper notice, scheduled reasonably necessary IEs, and did not violate the Human Rights Code.

The Tribunal concluded the applicant failed to attend the IEs without a reasonable excuse, and the respondent did not unreasonably delay or withhold benefits.

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

The insurer denied two treatment plans for a neurocognitive assessment and a psychological assessment, arguing they were duplicative and subject to the $2,000 statutory cap for a single assessment under s. 25(5)(a) of the Schedule.

The Tribunal found that the two assessments, although contained within the same report, were distinct, stand-alone evaluations addressing separate cognitive and psychological impairments.

The Tribunal ordered the insurer to pay the outstanding $2,200.00 for the assessments, plus interest.

The applicant sought a determination of catastrophic impairment following a motor vehicle accident that caused chronic regional pain syndrome, requiring a surgically implanted spinal cord stimulator.

The central issue was whether the applicant's gait derangement should be assessed with the stimulator turned on or off under the AMA Guides.

The Tribunal held that because the stimulator's use could be easily eliminated by turning it off, the assessment must be conducted with it off.

Preferring the applicant's expert evidence, the Tribunal found the applicant required more than one cane when the device was off, resulting in a 40% whole person impairment for gait derangement.

Combined with other ratings, the applicant met the 55% threshold and was deemed catastrophically impaired.

The court denied approval of a settlement for a party under disability due to significant deficiencies in the motion material.

These deficiencies included insufficient medical evidence to assess the injured party's present and future needs, lack of full disclosure regarding a companion tort action and any settlement offers therein, and inadequate details for the proposed allocation of settlement funds.

Furthermore, the court found insufficient information regarding a loan from counsel to the applicant and the fairness and reasonableness of the contingency fee agreement, which appeared to conflate tort and accident benefits claims.

The court also dismissed the request to seal the court record, emphasizing the high bar for such an extraordinary order.

The matter was to be re-submitted after the identified deficiencies were addressed.