Dr. Kevin J. Smith

The applicant sought statutory accident benefits following a motor vehicle accident, claiming she sustained a catastrophic impairment due to mental and behavioural disorders.

The Tribunal found the applicant met the catastrophic impairment threshold under Criterion 8, demonstrating marked impairments in activities of daily living, social functioning, and adaptation.

The Tribunal preferred the evidence of the applicant's assessors, noting the respondent's assessors failed to adequately consider the applicant's reliance on her partner and conducted flawed situational assessments.

The Tribunal awarded the cost of an in-home assessment but denied the claim for attendant care benefits, finding the proposed hours were overestimated and included tasks the applicant could perform independently.

The applicant, a taxi driver, was injured in a rear-end motor vehicle accident and sought statutory accident benefits.

The insurer terminated his income replacement benefits (IRBs) and denied certain medical and assessment treatment plans.

The arbitrator found that the applicant suffered from chronic pain syndrome and psychological impairments, entitling him to both pre-104-week and post-104-week IRBs.

The disputed medical and assessment plans were denied for lack of evidence of reasonableness and necessity at the time of submission.

The arbitrator awarded a maximum 50% special award against the insurer, finding it unreasonably withheld benefits by ignoring mounting medical evidence of the applicant's psychological and cognitive impairments and relying solely on outdated physical assessments.