Dr. Seiden

The applicant sought a preliminary order deeming him catastrophically impaired under Criterion 7 of the Statutory Accident Benefits Schedule, relying on a section 44 insurer examination by Dr. Waseem that concluded he met the 55% Whole Person Impairment threshold.

The respondent insurer opposed the motion, relying on conflicting section 44 assessments and an executive summary that concluded the applicant's wheelchair dependency was caused by pre-existing diabetes complications rather than the accident.

The Tribunal dismissed the applicant's request, holding that an insurer is not bound by the opinion of a single section 44 assessor and that a full hearing was required to weigh the complex medical evidence regarding causation.

The Tribunal also ordered the applicant to attend a section 44 psychiatric examination before proceeding with the application.

The Applicant was injured in a motor vehicle accident and sought a determination that she sustained a catastrophic impairment due to a psychiatric disorder.

The arbitrator found that the Applicant's treating psychiatrist provided sufficient evidence of a Marked Impairment under the AMA Guidelines, satisfying the catastrophic impairment threshold.

The arbitrator also awarded a special award of $9,629.70 against the Insurer for unreasonably delaying the payment of income replacement benefits for 527 days without a valid reason, but denied a special award for medical and attendant care benefits.