Dr. John Gilman

The applicant sought statutory accident benefits, claiming catastrophic impairment due to physical and psychological injuries from a 2015 motor vehicle accident.

The Tribunal found that the applicant failed to prove causation on a "but for" basis, noting that his psychological impairments were primarily caused by significant non-accident life stressors, including financial ruin and family breakdown.

The Tribunal also found the applicant did not meet the threshold for catastrophic impairment under Criterion 7 (Whole Person Impairment) or Criterion 8 (Mental and Behavioural Disorders).

Consequently, the claims for a neuro-psychological examination, attendant care benefits, and housekeeping and home maintenance benefits were dismissed.

The applicant sought a determination that she sustained a catastrophic impairment under Criteria 4 and 8 of the Statutory Accident Benefits Schedule following a motor vehicle accident, as well as entitlement to psychological services.

The Tribunal found that the applicant did not meet Criterion 4 because there were no positive findings of a traumatic brain injury on recognized diagnostic imaging.

The Tribunal also found that the applicant did not meet Criterion 8, as the evidence demonstrated she had been working part-time as a personal support worker, which was inconsistent with a Class 5 extreme impairment in work functioning.

The claim for psychological services was dismissed as not reasonable and necessary.

The respondent's request for costs was also dismissed.

The applicant sought medical and rehabilitation benefits under the Statutory Accident Benefits Schedule following a motor vehicle accident.

The disputed benefits included treatment plans for psychometric testing, a neuro-psychological examination, and a neuro-psychological intake interview recommended by her psychologist.

The adjudicator found that the applicant failed to prove the treatment plans were reasonable and necessary.

The adjudicator preferred the evidence of the respondent's multidisciplinary assessors, who concluded there was no ongoing accident-related brain injury or cognitive impairment.

The application was dismissed and no interest was payable.

The applicant, a self-employed bagel maker, claimed he lost his business due to physical and mental impairments sustained in a motor vehicle accident.

He sought income replacement benefits, attendant care, housekeeping, and a determination of catastrophic impairment due to a mental or behavioural disorder.

The insurer denied the claims, alleging the applicant was malingering.

The arbitrator found that while the applicant suffered from genuine psychological dysfunction, it predated the accident and was caused by pre-existing business, financial, and marital stressors.

The arbitrator concluded the applicant did not suffer a catastrophic impairment, failed to prove pre-accident self-employment income, and unreasonably withheld business records.

All claims were dismissed except for a small amount of incurred treatment expenses, for which a 50% special award was granted due to the insurer's unreasonable denial.

The appellant was injured in a motor vehicle accident and received income replacement benefits.

The insurer terminated benefits, arguing the appellant's ongoing disability was due to a pre-existing schizoaffective disorder rather than the accident.

The arbitrator agreed, finding the accident's material contribution to the disability ended by August 2001, and dismissed claims for various assessment expenses.

On appeal, the Director's Delegate upheld the arbitrator's decisions, finding no error of law in the arbitrator's evaluation of the medical evidence, the impact of the appellant's pre-existing condition, or the rejection of assessment expenses.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including income replacement benefits and medical/rehabilitation expenses.

The insurer terminated benefits, arguing the applicant's disability was due to a pre-existing schizoaffective disorder rather than the accident.

The arbitrator found that the trauma of the accident triggered an episode of the applicant's pre-existing psychiatric illness, entitling him to income replacement benefits for a limited period.

Claims for various assessments were largely dismissed, save for one functional capacity evaluation.

The claim for a special award was dismissed as the insurer's termination of benefits was not unreasonable given the complex medical evidence.

The appellant appealed an Arbitrator's decision dismissing his claims for income replacement benefits, medical expenses, and housekeeping benefits following a motor vehicle accident.

The Arbitrator had dismissed the claims primarily based on adverse credibility findings, noting inconsistencies between the appellant's reported symptoms and surveillance evidence showing him driving for extended periods.

The Director's Delegate dismissed the appeal, finding that the Arbitrator's factual conclusions were supported by the evidence and did not constitute an error of law.

The Arbitrator reasonably preferred the respondent's expert evidence and rejected the appellant's experts due to their reliance on the appellant's subjective and exaggerated complaints.

The applicant was injured in a rear-end motor vehicle accident and sought statutory accident benefits, including income replacement, medical, housekeeping, and examination expenses.

The insurer terminated income replacement benefits, arguing the applicant was malingering.

The arbitrator reviewed extensive medical evidence, surveillance footage, and the applicant's testimony.

The arbitrator found the applicant lacked credibility, noting inconsistencies between his claimed severe impairments, such as a driving phobia, and surveillance showing him driving for hours.

The arbitrator concluded the applicant was exaggerating his symptoms for financial gain and was capable of returning to work.

All claims for benefits and expenses were dismissed.