D. Zervas

The Applicant sought a determination that he sustained a catastrophic impairment and was entitled to ongoing income replacement benefits following a 2017 motor vehicle accident.

The Respondent brought a preliminary motion to strike the Applicant's catastrophic impairment report, arguing it was not conducted by a physician as required by section 45(2)1 of the Schedule.

The Tribunal dismissed the motion, finding the report was directed by a physician and compliant with the Schedule.

On the merits, the Tribunal preferred the Applicant's expert evidence, concluding he suffered a marked impairment in all four areas of functioning due to somatic symptom disorder and major depressive disorder.

The Tribunal found the Applicant catastrophically impaired and completely unable to engage in suitable employment, granting entitlement to income replacement benefits and interest.

The applicant was involved in a motor vehicle accident and sought income replacement benefits (IRBs) beyond the 104-week mark.

The respondent insurer terminated the benefits, relying on surveillance evidence of the applicant playing video games for extended periods and an assessment suggesting he could work in sedentary roles.

The Tribunal found that the applicant suffered from a mild traumatic brain injury and lumbar radiculopathy, which completely impaired his ability to engage in suitable employment.

The Tribunal rejected the respondent's reliance on the video game surveillance, noting that gameplay does not equate to competitive employability in a real-world setting.

The applicant was awarded ongoing IRBs and interest, but his claim for a special award for unreasonable withholding of benefits was dismissed.