Dr. James Delaney

The respondent requested reconsideration of a Licence Appeal Tribunal decision that awarded the applicant an income replacement benefit (IRB) and a vocational assessment treatment plan.

The respondent argued the Tribunal erred in its assessment of medical evidence regarding causation and the post-104 week IRB test.

The Vice-Chair dismissed the IRB grounds, finding the respondent was attempting to re-litigate the evidence.

However, the Vice-Chair found the Tribunal committed a legal error by approving the vocational assessment based on its relevance to the IRB determination rather than its necessity for the applicant's recovery.

The reconsideration was granted in part, and a written re-hearing was ordered solely for the vocational assessment treatment plan.

The applicant sought statutory accident benefits following a motor vehicle accident, including post-104 week income replacement benefits (IRBs) and various treatment plans.

The Tribunal found that the applicant suffered a complete inability to engage in any employment for which he was reasonably suited due to a severe shoulder injury requiring surgery, exacerbated by the accident, and awarded IRBs at the optional rate of $1,000 per week.

The Tribunal denied most of the disputed treatment plans for lack of supporting medical evidence, but approved a vocational assessment relevant to the IRB claim.

The request for a special award was dismissed as the insurer's denial was not found to be unreasonable, though interest was awarded on overdue benefits.

The Applicant was injured in a rear-end motor vehicle accident in November 2010 and sought a determination that she sustained a catastrophic impairment due to psychological issues.

The Insurer denied the claim, arguing the Applicant's mental health issues were due to a pre-existing bi-polar disorder and that she was malingering.

The Arbitrator found that the Applicant suffered a marked impairment in the area of adaptation and that the accident materially contributed to her current state of mental health.

The Arbitrator preferred the evidence of the Applicant's experts and noted the Insurer's aggressive tactics in summonsing witnesses.

The Arbitrator concluded the Applicant sustained a catastrophic impairment as a result of the accident.

The applicant, who was confined to a wheelchair following a motor vehicle accident, sought interim attendant care, caregiving, and housekeeping benefits after the insurer terminated them at the 104-week mark.

The insurer relied on a surveillance video and medical assessments suggesting the applicant was malingering.

The arbitrator found the surveillance video to be of questionable probative value and tainted the insurer's medical evidence.

Applying the prima facie and urgency/necessity tests, the arbitrator granted the interim benefits, noting the extraordinary hardship on the applicant's family who were providing his care.