Dr. Giselle Braganza

The applicant was injured in a severe motor vehicle accident and sought a determination that she sustained a catastrophic impairment under criterion 7 of the Statutory Accident Benefits Schedule.

The applicant claimed a combined whole person impairment (WPI) of 55%, relying on various physical and psychological assessments.

The respondent argued the WPI was 35%.

The Tribunal evaluated the competing expert medical evidence regarding the applicant's spinal impairments, scarring, headaches, vertigo, and psychological functioning.

Ultimately, the Tribunal preferred the respondent's experts on several key issues, concluding that the applicant's combined WPI was 50%.

As this fell short of the 55% threshold, the application was dismissed.

The applicant was injured in a motor vehicle accident and sought post-104-week income replacement benefits (IRBs).

The respondent denied the benefits, arguing the applicant did not suffer a complete inability to engage in any employment for which she was reasonably suited.

The Tribunal found that the applicant's physical impairments, specifically complex regional pain syndrome (CRPS) in her right arm, along with psychological impairments, prevented her from engaging in suitable employment, even on a part-time basis.

The Tribunal ordered the respondent to pay IRBs of $400 per week from September 1, 2022, plus interest.

The applicant's claim for an award under s. 10 of Regulation 664 for unreasonable withholding of benefits was dismissed.

The applicant was injured in a motor vehicle accident and sought various statutory accident benefits after being deemed catastrophically impaired.

The Licence Appeal Tribunal found that the applicant was entitled to assessments proposed by Omega Medical Assessments and attendant care benefits of $2,126.07 per month, as the medical evidence supported their reasonableness and necessity.

However, claims for rehabilitation services, a speech-language pathology assessment, fitness classes, and housekeeping benefits were dismissed due to insufficient evidence or surveillance contradicting the applicant's claims.

Interest was awarded on the payable benefits.

The applicant sought statutory accident benefits for a catastrophic impairment following a motor vehicle accident.

The Licence Appeal Tribunal had previously determined in a 2024 decision that the applicant did not sustain a catastrophic impairment.

The applicant filed a second application based on new medical reports.

The respondent raised the preliminary issue of res judicata.

The Tribunal found that the three preconditions for res judicata were met.

Furthermore, the Tribunal declined to waive the doctrine, finding that the new medical reports did not constitute fresh evidence that would conclusively impeach the original results, as they relied on the applicant's inaccurate self-reporting of her pre-accident condition.

The application was dismissed.

The applicant sought a determination that he sustained a catastrophic impairment under Criterion 8 (mental or behavioural disorder) following a 2017 motor vehicle accident.

The Tribunal evaluated the four domains of function under the AMA Guides.

Preferring the evidence of the applicant's experts, the Tribunal found the applicant sustained marked impairments in Activities of Daily Living, Concentration, Persistence and Pace, and Adaptation.

As the applicant demonstrated marked impairment in three domains, he met the test for catastrophic impairment.

The claim for a section 10 award was dismissed as no specific benefits were ordered payable.

The applicant sought a determination that she sustained a catastrophic impairment under Criterion 8 (mental or behavioural impairments) following a minor motor vehicle accident.

The Tribunal found that the applicant failed to establish that the accident was a necessary cause of her impairments, noting an extensive pre-accident medical history of physical and psychological disability that the applicant had minimized.

Furthermore, the Tribunal preferred the respondent's expert evidence, concluding that the applicant did not suffer a Class 4 marked impairment in three or more areas of functioning.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming her physical and psychological injuries, as well as chronic pain, warranted removal from the Minor Injury Guideline (MIG).

The respondent denied the claims, arguing the injuries were soft tissue in nature and resolved prior to a subsequent workplace accident.

The Tribunal found that the applicant failed to prove causation, as medical evidence indicated her motor vehicle accident injuries had resolved before the workplace incident.

The Tribunal also rejected the applicant's psychological and chronic pain claims, preferring the corroborating medical evidence that showed no such impairments prior to the workplace accident.

The application was dismissed, and the applicant was not entitled to the disputed treatment plans, an award, or interest.

The applicant sought statutory accident benefits following a motor vehicle accident, including a determination of catastrophic impairment and non-earner benefits.

The Licence Appeal Tribunal found the claim for non-earner benefits was statute-barred due to the applicant's failure to submit an OCF-3 within 104 weeks of the accident.

The Tribunal also concluded the applicant did not sustain a catastrophic impairment, preferring the respondent's psychiatric assessment over the applicant's, noting the applicant's assessor failed to consider a pre-existing ADHD diagnosis.

Claims for various treatment plans and expenses were dismissed for lack of evidence establishing reasonableness and necessity.

The applicant sought a catastrophic impairment designation due to a mental or behavioural disorder following a motor vehicle accident.

The Tribunal found that the applicant did not meet the criteria for a Class 4 (Marked) impairment in three of the four domains under the AMA Guides.

The evidence indicated that many of the applicant's functional limitations, including social withdrawal and learning difficulties, pre-dated the accident.

As the applicant was not catastrophically impaired and the non-catastrophic medical and rehabilitation limits were exhausted, the claims for treatment plans, a section 10 award, and interest were dismissed.

The applicant sought a determination that he sustained a catastrophic impairment following a motor vehicle accident, claiming a whole person impairment of 55% or more.

The Tribunal reviewed extensive medical evidence and expert testimony regarding the applicant's physical and psychological impairments, including gait derangement, spine impairment, traumatic brain injury, and mental/behavioural disorders.

The Tribunal concluded the applicant's combined whole person impairment was 41%, falling short of the 55% threshold.

Consequently, claims for attendant care beyond the 104-week limit were dismissed.

The Tribunal partially approved treatment plans for a chronic pain program, chiropractic spinal manipulation, and psychotherapy, subject to remaining policy limits.

Claims for a special award and costs were dismissed.

The applicant was injured in a motorcycle accident and sought a determination of catastrophic impairment (CAT) under the Statutory Accident Benefits Schedule, along with entitlement to three treatment plans.

The Tribunal found that the applicant's combined physical and psychological impairments resulted in a 48% whole person impairment, falling short of the 55% threshold required for a CAT designation under Criterion 7.

However, the Tribunal found the disputed treatment plans for physiotherapy and psychotherapy to be reasonable and necessary, ordering the respondent to pay them up to the medical and rehabilitation policy limit, plus interest.

The applicant sought a determination that he sustained a catastrophic impairment as a result of a motor vehicle accident, along with entitlement to attendant care and various medical and rehabilitation benefits.

The Licence Appeal Tribunal found that the applicant failed to prove a catastrophic impairment under Criterion 7, as his whole person impairment rating fell below the 55% threshold.

Consequently, the claim for attendant care benefits beyond the 104-week mark was denied.

However, the Tribunal ruled that the cost of a multidisciplinary catastrophic impairment assessment does not count towards the non-catastrophic medical and rehabilitation limits.

The Tribunal partially granted the claims for physiotherapy, chiropractic treatment, and specific assessment costs, while denying claims for an iPad, rehabilitation therapy, and an award for unreasonably withheld benefits.