Dr. Goodwin

The applicant sought various medical benefits, transportation expenses, and assessment costs under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The respondent denied the claims.

The Tribunal found the applicant's evidence lacked credibility due to inconsistent self-reports regarding the accident details and his functional limitations.

Relying on the respondent's independent medical examinations, which found the applicant had recovered and returned to his normal activities, the Tribunal concluded the applicant failed to prove the disputed treatment plans and assessments were reasonable and necessary.

The application was dismissed.

The applicant, a five-year-old pedestrian, was struck by a vehicle and sustained severe injuries, including a Glasgow Coma Scale (GCS) score of 9 recorded by paramedics shortly after the accident.

The insurer argued the low GCS score was caused by hemodynamic instability due to blood loss rather than a brain impairment.

The arbitrator found that the applicant suffered a brain impairment as a result of the accident, as the massive blood loss deprived the brain of oxygen, impairing its function and resulting in the GCS score of 9.

The arbitrator concluded the applicant met the definition of catastrophic impairment under subsection 2(1.1)(e)(i) of the Statutory Accident Benefits Schedule.