Dr. Stephen Lewis

The applicant sought various medical and rehabilitation benefits following a motor vehicle accident, including psychological services, a chronic pain assessment, an attendant care assessment, an orthopaedic assessment, and physical therapy.

The Licence Appeal Tribunal found that the applicant was entitled to the chronic pain assessment, as medical evidence supported ongoing pain symptoms.

However, the Tribunal denied the higher psychologist rate for services provided by a psychotherapist.

The Tribunal also denied the attendant care and orthopaedic assessments, as well as further physical therapy, finding them not reasonable and necessary given the applicant's return to work and studies, and the lack of objective orthopaedic impairment.

The claim for an award under s. 10 of Reg. 664 was dismissed due to procedural non-compliance.

The insurer appealed the Arbitrator's finding that the insured sustained a catastrophic impairment, arguing the Arbitrator applied the wrong causation test.

The insured cross-appealed the denial of Non-Earner Benefits, Housekeeping, and Attendant Care Benefits.

The Director's Delegate held that the 'but for' test, not the 'material contribution' test, is the correct causation test in accident benefits cases.

The Delegate found the Arbitrator misapprehended critical evidence regarding both the catastrophic impairment and Non-Earner Benefits claims, and remitted those issues for re-hearing.

The denial of Housekeeping and Attendant Care Benefits was upheld as the Arbitrator reasonably found the expenses were not incurred.

The applicant sought statutory accident benefits following a 2010 motor vehicle accident, claiming catastrophic impairment, attendant care, housekeeping, and non-earner benefits.

The insurer argued the applicant's impairments were solely due to pre-existing rheumatoid arthritis.

The arbitrator found the accident was a material contributing factor to the applicant's catastrophic impairment, relying on expert medical and psychological evidence.

However, the claims for attendant care and housekeeping benefits were dismissed because the applicant failed to provide documentary evidence that her service providers suffered an economic loss.

The claim for non-earner benefits was also dismissed due to insufficient evidence comparing pre- and post-accident activities.

The applicant was awarded $3,100 for the cost of examinations.