Dr. J. Mathoo

The applicant was injured in a motor vehicle accident and applied for a determination of catastrophic impairment under the Statutory Accident Benefits Schedule.

The core issue was whether his mental and behavioural impairments, specifically his cannabis dependence and adaptation difficulties, constituted a marked impairment (Class 4).

The arbitrator found the applicant's evidence lacking in credibility and preferred the insurer's expert evidence, concluding that the applicant's impairments were only moderate (Class 3) and his combined whole person impairment did not meet the 55% threshold.

The application was dismissed, and the insurer was awarded partial expenses due to the applicant's conduct prolonging the proceeding.

The applicant sought a determination that she was catastrophically impaired following a motor vehicle accident, claiming marked or extreme impairment due to a mental or behavioural disorder, or alternatively, a 55% or more whole person impairment (WPI).

The arbitrator found that the applicant did not suffer a marked or extreme mental or behavioural impairment.

After evaluating conflicting medical evidence regarding her physical and cognitive injuries, the arbitrator assessed her combined WPI at 28%, well below the 55% threshold.

The applicant was awarded $6,000 for the costs of catastrophic assessments, but her claims for attendant care benefits were dismissed.

The insurer was awarded its arbitration expenses.

The applicant was injured in a motor vehicle accident and applied for statutory accident benefits.

The insurer denied claims for attendant care, caregiver, and housekeeping benefits, arguing the applicant's injuries were minor and her presentation was not credible.

The arbitrator found that the applicant suffered significant psycho-emotional injuries, including chronic pain syndrome and post-traumatic stress disorder, resulting in a catastrophic impairment.

The arbitrator awarded attendant care benefits at the maximum rate of $6,000 per month, caregiver benefits for her younger son, and housekeeping benefits.

A claim for home modifications was denied as the renovations were planned prior to the accident.

The arbitrator also ordered a 10% special award against the insurer for unreasonably withholding payments without adequately assessing the medical evidence.

The applicant, a five-year-old pedestrian, was struck by a vehicle and sustained severe injuries, including a Glasgow Coma Scale (GCS) score of 9 recorded by paramedics shortly after the accident.

The insurer argued the low GCS score was caused by hemodynamic instability due to blood loss rather than a brain impairment.

The arbitrator found that the applicant suffered a brain impairment as a result of the accident, as the massive blood loss deprived the brain of oxygen, impairing its function and resulting in the GCS score of 9.

The arbitrator concluded the applicant met the definition of catastrophic impairment under subsection 2(1.1)(e)(i) of the Statutory Accident Benefits Schedule.