Dr. McKinnon

The insurer requested a reconsideration of a decision finding that the claimant sustained a catastrophic impairment.

The insurer argued the adjudicator erred in law and fact by accepting a neuropsychological assessment where the Extended Glasgow Outcome Scale (GOS-E) was administered by an occupational therapist rather than the neuropsychologist.

The adjudicator dismissed the request, finding no error of law because the Schedule permits a neuropsychologist to be assisted by other regulated health professionals.

While acknowledging a factual error regarding whether the insurer's assessor administered the GOS-E, the adjudicator concluded this error would not have changed the result, as the claimant's expert evidence was more consistent with the medical record.

The applicant was involved in a motorcycle accident and sustained a traumatic brain injury.

He applied for a catastrophic impairment determination under Criterion 4 of the Statutory Accident Benefits Schedule, relying on the Extended Glasgow Outcome Scale (GOS-E).

The adjudicator found that the applicant met the threshold for a lower moderate disability, primarily due to his inability to return to work in his previous capacity, and thus qualified for catastrophic impairment status.

The adjudicator also awarded partial attendant care benefits and approved several treatment plans for occupational therapy, psychological services, and a laptop, while denying other claimed medical benefits and a claim for a special award.

The minor applicant was struck by a garbage truck at age six and sought statutory accident benefits, claiming a catastrophic impairment.

The respondent insurer denied the catastrophic designation.

The Licence Appeal Tribunal considered competing neuropsychological evidence regarding the applicant's functioning and adaptation in the school setting.

The Tribunal preferred the evidence of the applicant's expert and found that the applicant sustained a class 4 marked impairment in adaptation due to mental and behavioural disorders caused by the accident.

The Tribunal concluded the applicant sustained a catastrophic impairment and is entitled to expanded benefits.

The applicant sought a determination that her accident-related impairments met the definition of a catastrophic impairment under the Statutory Accident Benefits Schedule.

The Tribunal found that the applicant sustained a marked impairment in the areas of activities of daily living, concentration, persistence and pace, and adaptation due to a mental or behavioural disorder.

The Tribunal preferred the evidence of the applicant's experts, noting the applicant's pre-existing vulnerabilities and significant post-accident functional decompensation.

As the applicant met the catastrophic threshold under section 3(2)(f), the Tribunal did not need to determine whether she met the 55% whole person impairment threshold under section 3(2)(e).