Dr. Craig Winsor

The applicant sought statutory accident benefits following a motor vehicle accident, arguing she should be removed from the Minor Injury Guideline (MIG) due to chronic pain with functional impairment.

The Tribunal found the applicant failed to prove on a balance of probabilities that her chronic pain was caused by the accident, noting her medical evidence was either remote in time, lacked detail, or failed to account for non-accident-related conditions such as psoriatic arthritis and a recent hospitalization for meningitis.

As the applicant remained within the MIG, her claims for physiotherapy treatment plans, interest, and an award for unreasonable delay were dismissed.

The applicant, a pedestrian struck by a motor vehicle, sustained a traumatic brain injury and multiple skull fractures.

She applied for catastrophic impairment designation under the Statutory Accident Benefits Schedule based on a Glasgow Outcome Scale (GOS) score of 3 (severe disability).

The insurer denied the designation, relying on a neurologist who found no physical neurological deficits.

The arbitrator rejected the insurer's narrow interpretation of the GOS, preferring the applicant's physiatrist who considered cognitive and behavioural impairments that rendered the applicant dependent on daily support.

The arbitrator found the applicant catastrophically impaired, awarded past and ongoing attendant care benefits for services provided by her husband, approved most of the disputed medical and rehabilitation treatment plans, and held the insurer liable for a special award for unreasonably withholding benefits.