Dr. Gerry Young

The applicant sought to vary or revoke an arbitrator's decision denying his claims for income replacement, attendant care, and housekeeping benefits, relying on new medical reports as 'new evidence'.

The Director's Delegate dismissed the application, finding that the proposed evidence could have been obtained prior to the original hearing with due diligence.

Furthermore, the Delegate held that even if admitted, the new evidence would not have led to a different result, as it did not address the arbitrator's core findings regarding the applicant's lack of credibility, failure to prove income loss, and demonstrated functional abilities.

The applicant, who sustained a catastrophic impairment including a traumatic brain injury in a motor vehicle accident, sought various medical and rehabilitation benefits under the Statutory Accident Benefits Schedule.

The insurer denied several treatment plans for physiotherapy, occupational therapy, speech-language therapy, and a multi-disciplinary residential program in the United States.

The arbitrator found that the insurer improperly relied on outdated or flawed assessor reports and failed to give adequate weight to the objective evidence of the applicant's treating professionals.

All disputed treatment plans were found to be reasonable and necessary, and the applicant was awarded the claimed benefits with interest.