Dr. D. Cohen

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit, the cost of a psychological assessment, and a plastic surgery consultation fee.

The Licence Appeal Tribunal dismissed the claims.

The Tribunal found the applicant did not suffer a complete inability to carry on a normal life, as evidence showed he maintained independence and returned to school and work.

While the psychological assessment was deemed reasonable and necessary, it was not payable because the cost had not been incurred.

The plastic surgery consultation fee was denied because it was incurred before a treatment plan was submitted.

The applicant was injured in two motor vehicle accidents and claimed income replacement benefits based on an alleged written contract of employment as a sales representative, which he claimed was signed before the first accident.

The insurer terminated benefits, arguing the contract was not legitimate.

The arbitrator found that the alleged contract did not represent the true relationship between the parties, concluding the applicant was likely a subcontractor working on strict commission rather than a salaried employee.

Consequently, the claim for income replacement benefits under paragraph 7(1)3 of the Statutory Accident Benefits Schedule was dismissed.

The arbitrator also reduced a claim for a $1,670 psychovocational assessment to $400, finding the full amount unreasonable.