Dr. Tejedin Getahun

The applicant sought statutory accident benefits following a motor vehicle accident, including a non-earner benefit and treatment plans for orthopedic, neurological, and psychological assessments.

The adjudicator dismissed the application in its entirety.

The adjudicator found that the insurer's denial notices complied with section 36(4) of the Schedule and that the applicant failed to prove a complete inability to carry on a normal life.

Furthermore, the requested medical assessments were deemed not reasonable and necessary, and the applicant failed to justify an enhanced hourly rate for psychological services.

Claims for a section 10 award and interest were also dismissed.

The applicant sought a determination of catastrophic impairment and entitlement to attendant care benefits and income replacement benefits following a motor vehicle accident.

The Licence Appeal Tribunal found that the applicant did not meet the criteria for catastrophic impairment under either Criterion 7 (55% whole person impairment) or Criterion 8 (mental and behavioural disorders).

The Tribunal preferred the evidence of the respondent's experts, noting significant validity concerns and sub-maximal effort during the applicant's assessments.

Consequently, the applicant was not entitled to enhanced attendant care benefits, having exhausted her non-catastrophic limits.

The Tribunal also dismissed the claim for income replacement benefits, finding the applicant failed to prove a substantial inability to perform the essential tasks of her pre-accident employment as a personal support worker.