The applicant, a 12-year-old, was seriously injured in a motor vehicle accident and sought a determination of catastrophic impairment under s. 3(2)(d)(i) of the Statutory Accident Benefits Schedule based on Glasgow Coma Scale (GCS) scores of 9 or less.
The respondent insurer denied the claim, arguing the applicant did not sustain a brain impairment and that the low GCS scores were invalid because they were confounded by medication and intubation, or recorded incorrectly.
The Tribunal found that the applicant sustained a concussion, which qualifies as a brain impairment.
Relying on the Court of Appeal's decision in Liu, the Tribunal held that the GCS criteria is a legal test, not a medical one, and declined to read in modifiers excluding scores affected by medication or intubation.
The Tribunal rejected the respondent's expert evidence attempting to invalidate the recorded scores, concluding the applicant met the criteria for catastrophic impairment.