Dr. D. Scott

The applicant was injured in a motor vehicle accident and sought a medical benefit for an occupational therapy treatment plan, which the respondent insurer denied.

The Tribunal found that the accident exacerbated the applicant's pre-existing chronic low back pain and caused new impairments, including neck pain and psychological symptoms.

Relying on the medical evidence, including the applicant's treating professionals and several independent assessments, the Tribunal concluded the treatment plan was reasonable and necessary to address her physical and psychological impairments.

The applicant was awarded the medical benefit and interest on overdue payments.

The applicant was injured in a motor vehicle accident and sought a determination that he sustained a catastrophic impairment due to mental and behavioural disorders.

The insurer brought a preliminary motion to dismiss the arbitration, arguing that a catastrophic determination without a claim for specified benefits was outside the arbitrator's jurisdiction.

The arbitrator dismissed the motion, finding jurisdiction to determine the status.

On the merits, the arbitrator preferred the evidence of the applicant's experts, finding that the insurer's psychiatrist failed to follow the AMA Guides by using a WSIB scale instead.

The arbitrator concluded the applicant suffered a Class 4 (Marked) impairment in deterioration or decompensation in a work or work-like setting, meeting the catastrophic impairment threshold.

The applicant's request for a special award was denied as no specific monetary benefits were unreasonably withheld.