Cristyn Franic

The applicant sought a determination that she sustained a catastrophic impairment under the ambulatory mobility criterion following a motor vehicle accident.

While the Tribunal accepted that the accident caused a severe and permanent alteration to the structure and function of her right leg, it rejected the SCIM scoring methodologies presented by both parties' experts.

The applicant's experts improperly scored her using a wheeled walker without a swing gait, and the respondent's expert improperly substituted his hand for a cane.

Without valid SCIM scoring evidence, the applicant failed to meet her burden of proof.

Claims for a walker and a CAT assessment were also dismissed as the applicant made no submissions to establish they were reasonable and necessary.

The applicant sought statutory accident benefits after witnessing a fatal bus accident, claiming it caused a catastrophic impairment (schizophrenia).

The respondent denied the benefits, arguing the applicant's condition was pre-existing or prodromal.

The Tribunal found that while the accident may have triggered an acute psychotic episode, the applicant was likely prodromal for years prior and failed to prove he sustained a Class 4 marked or Class 5 extreme impairment in the required spheres of function.

The Tribunal also dismissed claims for attendant care, rehabilitation support worker services, and other expenses, as the applicant's non-catastrophic policy limits were exhausted and the expenses were either not incurred or not reasonable and necessary.