6 total
Application for catastrophic impairment designation dismissed; surveillance and employment records contradicted self-reported limitations.
The applicant sought a determination of catastrophic impairment following a motor vehicle accident, claiming entitlement under Criteria 6, 7, and 8 of the Statutory Accident Benefits Schedule.
The Tribunal found that the applicant did not meet the threshold for catastrophic impairment, preferring the respondent's multidisciplinary assessments which were supported by objective evidence, including surveillance footage and employment records showing the applicant had returned to full-time work.
The Tribunal also dismissed the applicant's claims for the outstanding balance of a catastrophic impairment assessment plan, finding that clinical file reviews were subject to the $2,000 cap per assessment and that transportation expenses were not proven to exceed the 50-kilometre deductible.
Claims for interest and an award for unreasonable withholding of benefits were consequently dismissed.
Request for reconsideration of catastrophic impairment decision dismissed as no errors of law or fact were found.
The applicant requested a reconsideration of a decision finding she was not catastrophically impaired under Criterion 8 of the Schedule.
The applicant argued the adjudicator erred in law and fact by misapplying the Schedule, rejecting expert psychiatric opinions, misapplying the causation test, and ignoring evidence of deterioration.
The Tribunal dismissed the request, finding no errors of law or fact that would have changed the outcome.
The adjudicator noted that assigning weight to evidence and preferring certain evidence over expert opinions falls within the adjudicator's role and does not constitute an error of law.
Applicant designated catastrophically impaired due to marked psychological impairment in activities of daily living.
The applicant was involved in a motor vehicle accident and sought a determination of catastrophic impairment (CAT) due to psychological injuries, including PTSD and a relapse of Major Depressive Disorder.
The respondent denied the CAT designation based on its assessors' conclusions that the applicant suffered only moderate impairments.
The Tribunal preferred the evidence of the applicant's assessors, finding that the respondent's psychiatric assessment lacked thoroughness and failed to properly consider the applicant's reduced functioning in activities of daily living.
The Tribunal concluded that the applicant sustained a Class 4 (marked) impairment in at least one area of functioning and therefore met the definition of catastrophic impairment under the Schedule.
The Tribunal also granted the applicant's request to anonymize her name and limit public access to the adjudicative records due to the sensitive nature of her mental health information.
Reconsideration request dismissed; alleged factual error regarding causation would not change the outcome.
The applicant requested a reconsideration of a previous Licence Appeal Tribunal decision which found she did not sustain a catastrophic impairment.
The applicant argued the tribunal made an error of fact by stating the respondent's position was that her psychological impairments were pre-existing, when the respondent had conceded some impairments were caused by the accident.
The tribunal dismissed the request, finding that even if an error of fact was made regarding causation, it would not change the outcome because the original decision was based solely on the applicant's level of function not meeting the threshold for a catastrophic impairment.
Catastrophic impairment claim dismissed; psychological and functional limitations largely pre-dated the motor vehicle accident.
The applicant sought a determination that she sustained a catastrophic impairment (CAT) under Criterion 8 of the Statutory Accident Benefits Schedule following a motor vehicle accident.
The respondent argued the application was barred by res judicata and abuse of process due to a prior Tribunal decision denying post-104-week income replacement benefits.
The Tribunal rejected the preliminary objections, finding the applicant relied on new medical evidence.
On the merits, the Tribunal found the applicant's impairments, including her psychological and chronic pain conditions, largely pre-dated the accident.
The Tribunal rejected the applicant's expert evidence as flawed and concluded she did not suffer a marked impairment in three of four domains of function.
The application was dismissed.
Catastrophic impairment claim dismissed; applicant's experts given limited weight due to concealed functional activities.
The applicant sought a determination that she sustained a catastrophic impairment due to mental or behavioural disorders following a motor vehicle accident.
The Tribunal found that the applicant failed to prove a marked impairment in the adaptation domain.
The Tribunal placed limited weight on the applicant's experts because the applicant had concealed significant functional activities, such as independently driving to Nova Scotia and planning a wedding, and because her psychiatrist strayed into advocacy.
The application was dismissed, and no award for unreasonable delay was granted.
The Tribunal also ordered the applicant's name initialized to protect her safety as a survivor of intimate partner violence.
No co-appearing lawyers found.
No judges found.