Dr. D.M.

The applicant sought ongoing income replacement benefits (IRBs) following a motor vehicle accident, claiming that his daily use of marijuana to control anxiety and pain prevented him from working.

The respondent had terminated IRBs based on insurer's examinations and sought repayment of an overpayment, alleging wilful misrepresentation of the applicant's employment status.

The Tribunal found that the applicant failed to prove his marijuana dependency or other impairments resulted in a substantial inability to perform the essential tasks of his employment.

The Tribunal also dismissed the respondent's claim for repayment, finding no wilful misrepresentation and noting the respondent failed to provide notice within the 12-month limitation period.

Claims for a special award and costs were also dismissed.

The applicant, an eight-year-old with severe pre-existing disabilities, was struck by a vehicle and sustained a traumatic brain injury.

He applied for a determination of catastrophic impairment under s. 3(2)(d)(ii) of the Statutory Accident Benefits Schedule, arguing that the accident significantly increased his dependency and need for daily support.

The respondent argued that the accident did not exacerbate his pre-existing impairments.

The Tribunal found the applicant's evidence, including his mother's testimony and the Omega Medical Associates assessment, more compelling.

The Tribunal concluded that the applicant's condition worsened significantly after the accident, increasing his dependencies, and deemed him catastrophically impaired.