Dr. Emily Gavett-Liu

The applicant sought a determination of catastrophic impairment and entitlement to attendant care benefits and hearing aids following a motor vehicle accident.

The Licence Appeal Tribunal found that the applicant was statute-barred from claiming attendant care benefits because she failed to dispute the insurer's denial within the two-year limitation period, and the justice of the case did not warrant an extension.

On the issue of catastrophic impairment, the Tribunal applied the AMA Guides to assess the applicant's physical and psychological impairments, ultimately finding a combined Whole Person Impairment (WPI) of 56%, which exceeds the 55% threshold under Criterion 7.

The Tribunal denied the claim for hearing aids because the applicant incurred the expense without first submitting a treatment plan, contrary to section 38(2) of the Schedule.

The claim for a special award was also dismissed as the insurer did not unreasonably withhold or delay benefits.

The applicant sought a determination that she sustained a catastrophic impairment under Criterion 8 of the Schedule following a 2022 motor vehicle accident.

The respondent denied the claim, arguing her impairments stemmed from pre-existing conditions, including a prior accident and childhood trauma.

The Tribunal applied the 'but for' test for causation and found that the 2022 accident exacerbated her pre-existing psychological issues, resulting in marked impairments in activities of daily living, social functioning, and adaptation.

The Tribunal preferred the evidence of the applicant's experts and found she met the threshold for catastrophic impairment.

The applicant requested reconsideration of a Tribunal decision denying her claim for statutory accident benefits.

The applicant had witnessed a motor vehicle accident that resulted in the death of her husband and claimed psychological injuries from the event.

The original decision found she was not 'involved in' the accident under s. 3(1)(b) of the Schedule because she was merely a witness and was not struck by a vehicle.

On reconsideration, the applicant alleged factual errors regarding the medical evidence and the identity of the vehicle, as well as legal errors in the application of case law.

The Tribunal dismissed the request, finding that the applicant was attempting to re-weigh evidence and re-litigate the case, and that she failed to establish any material error of fact or law that would have changed the outcome.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming she sustained a catastrophic impairment due to mental and behavioural disorders.

The Tribunal found the applicant met the catastrophic impairment threshold under Criterion 8, demonstrating marked impairments in activities of daily living, social functioning, and adaptation.

The Tribunal preferred the evidence of the applicant's assessors, noting the respondent's assessors failed to adequately consider the applicant's reliance on her partner and conducted flawed situational assessments.

The Tribunal awarded the cost of an in-home assessment but denied the claim for attendant care benefits, finding the proposed hours were overestimated and included tasks the applicant could perform independently.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits, including a determination of catastrophic impairment under criterion 8 (mental and behavioural impairments).

The Licence Appeal Tribunal found that the applicant suffered a marked impairment in three spheres of functioning (Activities of Daily Living, Social Functioning, and Adaptation) and was therefore catastrophically impaired.

The Tribunal awarded attendant care benefits of $3,233.31 per month but dismissed the applicant's claims for various treatment plans, assessments, and a special award, finding insufficient evidence to support those claims.

The applicant sought statutory accident benefits following a 2021 motor vehicle accident.

The Tribunal found the applicant sustained a catastrophic impairment under Criterion 8 due to marked impairments in all four areas of function (activities of daily living, social functioning, concentration, persistence and pace, and adaptation) stemming from accident-related mental and behavioural disorders, including somatic symptom disorder and exacerbated PTSD.

However, the Tribunal dismissed the claims for a non-earner benefit, attendant care benefits, and various treatment plans, finding the applicant did not suffer a complete inability to carry on a normal life and failed to prove the treatment plans were reasonable and necessary.

The applicant sought accident benefits following a motor vehicle collision, disputing the insurer's determination that his injuries fell within the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG based on a concussion, chronic pain, and psychological impairments.

The Tribunal found insufficient medical evidence to support a concussion or chronic pain diagnosis, and preferred the respondent's psychological assessments which found symptom exaggeration over the applicant's assessments.

The Tribunal concluded the applicant's injuries were predominantly minor.

The applicant's claims for treatment plans outside the MIG limit, a non-earner benefit, and an award for unreasonable delay were all dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including attendant care benefits, occupational therapy, psychological counselling, kinesiology, and psychotherapy.

The Tribunal found the applicant was not entitled to attendant care benefits as they were not incurred.

However, the Tribunal approved the treatment plans for occupational therapy, psychological counselling, and virtual kinesiology, finding them reasonable and necessary based on the recommendations of various assessors and treatment providers.

The plan for psychotherapy by a registered nurse was denied as redundant.

The claim for a special award was dismissed, but interest was awarded on overdue benefits.

The applicant sought statutory accident benefits for psychological injuries sustained after witnessing a police cruiser strike hydro wires, which subsequently killed her husband.

The respondent denied the claim on the basis that the applicant was not an 'insured person' under s. 3(1) of the Statutory Accident Benefits Schedule.

The Licence Appeal Tribunal found that the applicant was merely a bystander and was not 'involved in' the accident, as she was not struck by the vehicle and her psychological impairments stemmed from grief rather than a fear for her own safety.

The application for benefits was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming catastrophic impairment due to mental and behavioural disorders under Criterion 8 of the Schedule.

The Tribunal found that the applicant sustained a marked impairment in three domains of functioning: activities of daily living, adaptation, and social functioning, preferring the evidence of the applicant's psychiatrist over the respondent's.

The Tribunal concluded the applicant was catastrophically impaired.

However, the applicant's claim for a psychological services treatment plan was dismissed as he failed to provide evidence establishing it was reasonable and necessary.

The applicant sought a determination of catastrophic impairment and entitlement to attendant care benefits and income replacement benefits following a motor vehicle accident.

The Licence Appeal Tribunal found that the applicant did not meet the criteria for catastrophic impairment under either Criterion 7 (55% whole person impairment) or Criterion 8 (mental and behavioural disorders).

The Tribunal preferred the evidence of the respondent's experts, noting significant validity concerns and sub-maximal effort during the applicant's assessments.

Consequently, the applicant was not entitled to enhanced attendant care benefits, having exhausted her non-catastrophic limits.

The Tribunal also dismissed the claim for income replacement benefits, finding the applicant failed to prove a substantial inability to perform the essential tasks of her pre-accident employment as a personal support worker.

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 sought statutory accident benefits following a 2013 motor vehicle accident, claiming catastrophic impairment due to psychiatric issues.

The Licence Appeal Tribunal found the applicant sustained a catastrophic impairment under Criterion 8 (marked impairment in social functioning) based on psychiatric evidence showing severe social isolation and altercations.

The Tribunal awarded $2,000 for a psychiatric assessment but denied the remaining $13,005 claimed for other assessments.

Claims for an award under s. 10 of Reg. 664 were dismissed.

Procedural requests by the applicant for the adjudicator's recusal and a video recording of the hearing were also denied.

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 and was entitled to attendant care benefits following a motor vehicle accident.

The Tribunal found that the applicant did not sustain a catastrophic impairment, as her psychological and physical impairments did not meet the threshold of three or more marked impairments under Criterion 8.

The Tribunal also denied the claim for attendant care benefits, finding that the applicant failed to prove her spouse suffered an economic loss to provide the care, and therefore the expenses were not incurred.

Claims for interest and a special award were also dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident while he was a passenger in a stolen truck.

The Tribunal found that the applicant knew or ought to have known the vehicle was stolen, barring him from receiving income replacement benefits under section 31 of the Schedule.

The Tribunal also determined that the applicant did not sustain a catastrophic impairment, preferring the respondent's expert evidence that the applicant's mental and behavioural issues, including substance abuse, predated the accident.

All claims for benefits, interest, and awards were dismissed.

The respondent was awarded $300 in costs due to the applicant's unreasonable conduct in failing to attend cross-examination.

The applicant sought statutory accident benefits following a motor vehicle accident while a passenger in a stolen truck.

The Tribunal found that the applicant knew or ought to have known the vehicle was stolen, barring him from receiving income replacement benefits under section 31(1)(c) of the Schedule.

The Tribunal also determined that the applicant did not sustain a catastrophic impairment under Criterion 8, preferring the respondent's medical assessments which indicated his mental and behavioural impairments were largely pre-existing and related to longstanding substance abuse.

The applicant's claims for benefits, interest, and an award were dismissed, and costs of $300 were awarded to the respondent due to the applicant's failure to attend cross-examination.

The applicant sought various statutory accident benefits following a motor vehicle accident, including multiple treatment plans for physiotherapy and psychological services, attendant care benefits, and the cost of an accounting report for income replacement benefits.

The Tribunal dismissed the application in its entirety.

The Tribunal found the applicant failed to prove the treatment plans were reasonable and necessary, noting inconsistencies in self-reported improvement and accepting medical evidence that the applicant required a multi-disciplinary chronic pain program rather than further facility-based physical therapy.

The Tribunal also denied the cost of the accounting report, finding the applicant's income calculation was straightforward and did not require an accountant's expertise.

Claims for attendant care benefits, interest, and a special award were similarly dismissed.

The applicant sought a determination that she sustained a catastrophic impairment under Criterion 8 (mental or behavioural impairments) following a minor motor vehicle accident.

The Tribunal found that the applicant failed to establish that the accident was a necessary cause of her impairments, noting an extensive pre-accident medical history of physical and psychological disability that the applicant had minimized.

Furthermore, the Tribunal preferred the respondent's expert evidence, concluding that the applicant did not suffer a Class 4 marked impairment in three or more areas of functioning.

The application was dismissed.

The applicant sought statutory accident benefits, claiming a catastrophic impairment due to mental and behavioural disorders following a motor vehicle accident.

The Licence Appeal Tribunal found that the applicant did not sustain a marked impairment in social functioning, as his self-reports were inconsistent with direct observations by psychiatrists, family testimony, and surveillance evidence.

Because the applicant could not establish a marked impairment in at least three areas of function, the application was dismissed.