Dr. S. Patel

The applicant was severely injured in a head-on motor vehicle collision and applied for statutory accident benefits.

After exhausting non-catastrophic limits, she sought a determination of catastrophic impairment and entitlement to further attendant care, housekeeping, and medical/rehabilitation benefits.

The Tribunal found the applicant catastrophically impaired under Criterion 7, accepting a combined Whole Person Impairment rating of 59% based on physical and mental/behavioral impairments, including a mild traumatic brain injury.

The Tribunal awarded attendant care and housekeeping benefits for incurred amounts, as well as an occupational therapy treatment plan, but dismissed claims for physiotherapy and a special award.

The applicant was also ordered to repay income replacement benefits received while employed.

The applicant sought statutory accident benefits following a motor vehicle accident.

The insurer denied funding for physiotherapy, chiropractic treatment, and a psychological assessment, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant suffered from vehicular anxiety, a psychological injury that removed him from the MIG.

However, the physical treatment plans were denied as there was no evidence of physical injury.

The psychological assessment was approved subject to the $2,000 statutory limit.

The applicant sought ongoing income replacement benefits (IRBs) more than 104 weeks after a motor vehicle accident, claiming a complete inability to work due to chronic pain and psychological impairments.

The respondent insurer terminated IRBs based on insurer examinations indicating the applicant could perform alternative employment.

The Licence Appeal Tribunal found that the applicant's condition had improved, she had reached maximum medical improvement, and she possessed transferable skills suitable for roles such as a beauty salon attendant or cashier.

The Tribunal concluded the applicant failed to meet the post-104 week disability test.

Additionally, the applicant's claim for the cost of a chronic pain assessment was denied because it was incurred before submitting a treatment plan, contrary to section 38(2) of the Schedule.

The application was dismissed.