Dr. Stephen W. Bartol

The applicant sought payment for a psychological services treatment plan and an award for unreasonable delay under the Statutory Accident Benefits Schedule following a 2016 motor vehicle accident.

The Tribunal found the psychological services were not reasonable and necessary, relying on an insurer's examination that concluded the applicant did not meet the diagnostic threshold for a psychological disorder.

However, the Tribunal granted a 20% award under section 10 of Regulation 664, finding the respondent unreasonably delayed approval of a previously submitted occupational therapy treatment plan for nearly two years without explanation.

The applicant was injured in a rear-end motor vehicle accident and received statutory accident benefits until they were terminated by the insurer.

More than a year after the accident, she was diagnosed with left shoulder rotator cuff tendonitis, which required surgery.

The insurer disputed that the shoulder condition was caused by the accident and argued the applicant was not disabled from her job as a cashier.

The arbitrator found that the shoulder condition was caused by the accident, likely due to the shoulder belt or traction effect, and that it rendered her substantially unable to perform the essential tasks of her employment.

The arbitrator awarded ongoing weekly income benefits, supplementary medical and rehabilitation expenses, and a special award for the insurer's unreasonable withholding of chiropractic expenses.