Dr. D. Kurzman

The applicant sought a determination that he sustained a catastrophic impairment under criterion 4 of the Statutory Accident Benefits Schedule following a motor vehicle accident.

The applicant relied on a SPECT scan to demonstrate a traumatic brain injury.

The Tribunal found that a SPECT scan is not a medically recognized brain diagnostic technology, as it is not sufficiently reliable to identify a traumatic brain injury resulting from an accident.

Furthermore, the Tribunal preferred the respondent's radiological evidence, which concluded that the SPECT scan findings were nonspecific and could be explained by other etiologies, such as pre-existing psychological conditions or prior head traumas.

The application was dismissed, and no award for unreasonable delay was granted.

The applicant sought a determination that she sustained a catastrophic impairment due to a mental or behavioural disorder following a motor vehicle accident.

The adjudicator found that the applicant's pre-existing physical and cognitive conditions, including brain lesions and diabetes, were the primary cause of her functional limitations.

The adjudicator rejected the applicant's psychiatric expert evidence, finding it overstated her pre-accident functioning and improperly conflated physical and mental impairments.

The application was dismissed, as the applicant failed to demonstrate a marked impairment in three or more domains of function.

The applicant sought a determination that she was catastrophically impaired following a motor vehicle accident, claiming marked or extreme impairment due to a mental or behavioural disorder, or alternatively, a 55% or more whole person impairment (WPI).

The arbitrator found that the applicant did not suffer a marked or extreme mental or behavioural impairment.

After evaluating conflicting medical evidence regarding her physical and cognitive injuries, the arbitrator assessed her combined WPI at 28%, well below the 55% threshold.

The applicant was awarded $6,000 for the costs of catastrophic assessments, but her claims for attendant care benefits were dismissed.

The insurer was awarded its arbitration expenses.

The insurer appealed and the claimant cross-appealed an Arbitrator's decision regarding attendant care benefits (ACBs) and a special award for unreasonably withheld income replacement benefits (IRBs) following a motor vehicle accident.

The Director's Delegate corrected mathematical and rate errors in the Arbitrator's ACB calculation, increasing the monthly amount to $1,615.32.

The Delegate upheld the Arbitrator's factual finding that the claimant did not require 24-hour supervisory care, preferring the insurer's occupational therapy evidence over the claimant's assessor, who was found to lack objectivity.

The Delegate also held that section 39(3) of the SABS does not bar retroactive ACB claims, as it governs the timing of payment rather than entitlement.

The insurer's appeal against the special award was dismissed, as evidence supported the finding that IRBs were unreasonably withheld.