Dr. Drzymala

The applicant and respondent both filed requests for reconsideration of a Licence Appeal Tribunal decision regarding statutory accident benefits.

The applicant argued the adjudicator made errors of fact and law in finding no causal link between the motor vehicle accident and the applicant's subsequent heart failure and stroke.

The Tribunal dismissed the applicant's request, finding the adjudicator correctly applied the 'but for' test and made no reviewable errors in weighing the medical evidence.

The respondent argued the adjudicator violated procedural fairness by awarding the cost of an attendant care assessment based on section 25(1)4 of the Schedule, a provision neither party had addressed in submissions.

The Tribunal granted the respondent's request, finding the adjudicator should have sought submissions on the section, and ordered the issue of the attendant care assessment to be re-heard.

The applicant sought entitlement to an income replacement benefit and several treatment and assessment plans following a motor vehicle accident.

The respondent denied the income replacement benefit, arguing that the applicant's inability to work was due to congestive heart failure, a stroke, and cardiac arrhythmia that were not caused by the accident.

The adjudicator applied the 'but for' test and found that the applicant failed to establish a causal link between the accident and his subsequent cardiac and neurological conditions.

Consequently, the claim for an income replacement benefit was dismissed.

However, the adjudicator found that the applicant was entitled to medical benefits for chiropractic and psychological services, as well as the cost of an attendant care assessment, because these were reasonable and necessary to treat accident-related impairments.

A treatment plan for other goods and services was denied.