Dr. Jwely

The applicant was injured in a rear-end motor vehicle accident and sought statutory accident benefits, including a determination of catastrophic impairment.

The Licence Appeal Tribunal found that the applicant sustained a catastrophic impairment under Criterion 8, concluding she suffered a class 5 extreme impairment in social function and class 4 marked impairments in concentration, persistence, pace, and adaptation due to mental and behavioural disorders.

The Tribunal awarded attendant care benefits at a reduced rate of $785.25 per month and approved several medical and rehabilitation treatment plans, including occupational therapy, physiotherapy, aquatherapy, and pet therapy.

The Tribunal also ordered the respondent to pay a 50% special award under s. 10 of Reg. 664, totaling $7,336.27, finding that the insurer unreasonably denied critical treatment plans early in the applicant's recovery.

The applicant was struck by a vehicle as a pedestrian and sought statutory accident benefits, including a determination of catastrophic impairment, income replacement benefits (IRBs), and various medical benefits.

The Tribunal found that the applicant did not sustain a catastrophic impairment, as his physical and psychological impairments did not meet the 55% whole person impairment threshold under criteria 6 and 7, nor did he suffer marked impairments in three domains under criterion 8.

The Tribunal also dismissed the claim for IRBs, noting the applicant had returned to work for nearly three years post-accident and failed to demonstrate a complete inability to engage in suitable employment.

Claims for a functional abilities evaluation and worksite assessment were dismissed as not reasonable and necessary.

The applicant was awarded minor amounts for treatment plan form fees and interest on those amounts, but the claim for a special award was dismissed as the insurer's denials were not unreasonable.

The applicant sought a determination that he sustained a catastrophic impairment following a motor vehicle accident, relying on Criteria 7 and 8 of the Statutory Accident Benefits Schedule.

The Licence Appeal Tribunal dismissed the application, finding the applicant did not meet the 55% whole-person impairment threshold under Criterion 7 or demonstrate three marked impairments under Criterion 8.

The Tribunal gave no weight to the reports of the applicant's medical experts who failed to attend the hearing for cross-examination, and preferred the evidence of the respondent's assessors, which showed only mild physical and psychological impairments.

The applicant sought a determination that he sustained a catastrophic impairment as a result of a motor vehicle accident under Criteria 7 and 8 of the Statutory Accident Benefits Schedule.

The Tribunal weighed competing multidisciplinary expert reports.

The Tribunal gave no weight to the applicant's orthopaedic and psychiatric experts because they failed to attend the hearing for cross-examination, and found the applicant's occupational therapist's evidence unreliable due to inconsistencies with observed function.

Preferring the respondent's experts, the Tribunal found the applicant sustained a 5% physical WPI and 5% psychological WPI, failing to meet the 55% threshold under Criterion 7, and sustained only mild impairments in the spheres of functioning under Criterion 8.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming she sustained a catastrophic impairment.

The Licence Appeal Tribunal assessed her physical and psychological impairments under Criteria 7 and 8 of the Schedule.

The Tribunal found the applicant's Whole Person Impairment rating was 41%, falling short of the 55% threshold, and that she suffered only moderate, not marked or extreme, psychological impairments.

Claims for a non-earner benefit, attendant care benefits, and various treatment plans were also dismissed due to insufficient evidence and failure to meet the respective legal tests.

The application was dismissed in its entirety.

The applicant sought a determination of catastrophic impairment under Criterion 8 of the SABS following a motor vehicle accident, along with a treatment plan for CAT assessments and an award.

The Tribunal found that the applicant suffered from moderate impairments in activities of daily living and social functioning, but did not meet the threshold of three marked impairments or one extreme impairment required for a catastrophic designation.

The Tribunal noted that the applicant's physical limitations, rather than her psychological symptoms, primarily restricted her activities of daily living.

The claims for the treatment plan, interest, and an award were dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident.

The Tribunal found the applicant sustained a catastrophic impairment under Criterion 7, reaching a 57% whole-person impairment rating.

The Tribunal also found the applicant met the test for post-104 income replacement benefits due to a complete inability to engage in suitable employment, but denied payment because the applicant failed to file income tax returns as required by section 4(5) of the Schedule.

Finally, the Tribunal determined the applicant was entitled to attendant care benefits of $889.21 per month, but denied payment because the expenses were not incurred.

The applicant requested a reconsideration of a Tribunal decision that found she was not catastrophically impaired under criterion 8 of the AMA Guides.

The applicant argued the Tribunal breached procedural fairness by considering pre- and post-accident levels of function and erred in law by imposing a higher burden of proof for marked impairments in three domains.

The Tribunal dismissed the request, finding no error of law or fact and no breach of procedural fairness.

The Tribunal held that it properly applied the AMA Guides, appropriately weighed the medical evidence, and correctly placed less weight on an occupational therapy report that lacked an in-home assessment.

The applicant sought accident benefits following a motor vehicle accident, claiming she sustained a catastrophic impairment due to psychological issues.

The Tribunal found that the applicant's extensive pre-existing psychological conditions were the primary cause of her impairments, and the accident was not a necessary cause.

The Tribunal preferred the respondent's medical evidence, noting the applicant's self-reports were inconsistent with her medical records, which showed improvement post-accident.

The application for catastrophic impairment, non-earner benefits, and other medical benefits was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming catastrophic impairment under Criterion 8 due to mental and behavioral disorders.

The Licence Appeal Tribunal found that the applicant's pre-existing irritable bowel syndrome and depression, along with the loss of family members, were the primary causes of her impairments.

The Tribunal preferred the respondent's expert evidence, concluding the applicant suffered only moderate (Class 3) impairments in activities of daily living, social functioning, and concentration, persistence, and pace.

As the applicant did not meet the threshold for catastrophic impairment and had exhausted her $65,000 non-catastrophic limits, all claims for disputed treatment plans and expenses were dismissed.

The applicant sought a determination of catastrophic impairment and entitlement to various medical and rehabilitation benefits following a motor vehicle accident.

The Tribunal found the applicant catastrophically impaired under Criterion 8 of the Schedule, concluding he suffered marked impairments in social functioning, concentration, persistence and pace, and adaptation due to a mental and behavioural disorder.

The Tribunal preferred the evidence of the applicant's psychiatrist over the respondent's assessor, who failed to attend the hearing.

The Tribunal approved the majority of the disputed treatment plans, including occupational therapy, chiropractic services, physiotherapy, and a catastrophic assessment, but denied a pharmacotherapy plan for medical cannabis as the requested amount exceeded the applicant's stated needs.

The applicant sought a determination that they sustained a catastrophic impairment due to a mental or behavioural disorder following a motor vehicle accident.

The Tribunal applied the AMA Guides 4th Edition to assess the applicant's functioning in four spheres.

Relying on surveillance evidence, social media posts, and the respondent's medical experts, the Tribunal found the applicant's self-reported limitations were inconsistent with their actual activities, which included home renovations, driving, and running a business.

The Tribunal concluded the applicant did not suffer a marked impairment in any of the four spheres and dismissed the application.