The applicant sought statutory accident benefits following a 2017 motor vehicle accident.
She applied for a catastrophic impairment determination based on psychological and neurological impairments.
The Tribunal found the applicant was not catastrophically impaired, as her mental and behavioural disorders resulted in only mild impairments in social functioning and concentration, persistence, and pace, and there was insufficient evidence of a mild traumatic brain injury to meet the 55% whole person impairment threshold.
The Tribunal allowed the applicant to change her election from a non-earner benefit to an income replacement benefit, finding the initial election invalid because the insurer failed to provide a proper explanation of benefits.
The insurer was granted a repayment of the non-earner benefit due to deductible collateral benefits.
The Tribunal approved one occupational therapy treatment plan and awarded a 10% special award under s. 10 of O. Reg. 664, finding the insurer unreasonably maintained its denial despite acknowledging the plan should have been reassessed.
Claims for a massage chair, attendant care benefits, and other assessments were dismissed.
