Dr. Chris Hope

The applicant, who sustained catastrophic impairments in a motorcycle accident, sought various statutory accident benefits denied by the respondent insurer.

The Licence Appeal Tribunal found the applicant entitled to attendant care benefits of $6,000 per month, preferring the evidence of the applicant's occupational therapists who accounted for his fluctuating daily functionality over the respondent's assessor.

The Tribunal also awarded $87,809 for home modifications and capped the assessment cost at $2,200, finding most proposed modifications reasonable and necessary.

The claim for dietician services was granted due to the applicant's accident-related appetite loss and blood sugar management issues.

However, the Tribunal denied funding for service dog training, finding insufficient evidence that it was a reasonable and necessary medical benefit, and declined to order a special award as the insurer's denials were not unreasonable.

The applicant sought income replacement benefits (IRBs) and a determination of catastrophic impairment following a motor vehicle accident.

The central factual dispute was whether the applicant's blackouts were caused by the accident or were a pre-existing condition.

The Tribunal found that the blackouts were a symptom of accident-related PTSD, which was exacerbated by a subsequent near-miss incident.

The Tribunal awarded pre-104 week IRBs, finding the applicant suffered a substantial inability to perform her pre-accident employment tasks.

However, post-104 week IRBs were denied as the applicant failed to prove a complete inability to engage in suitable alternative employment.

The Tribunal also concluded that the applicant sustained a catastrophic impairment due to a Class 4 marked psychological impairment affecting her activities of daily living and adaptation.