Dr. L. Davidson

The applicant sought statutory accident benefits following a 2019 motor vehicle accident, claiming catastrophic impairment due to mental and behavioural impairments.

At the outset of the hearing, the adjudicator denied the applicant's request for an adjournment, noting the significant delay, previous adjournments, and the new counsel's lack of preparation.

The hearing proceeded with the applicant self-represented after her counsel failed to appear.

The adjudicator found the applicant did not sustain a catastrophic impairment, as she failed to prove a marked impairment in three of the four spheres of functioning under Criterion 8.

The adjudicator also dismissed the claims for post-104-week income replacement benefits and attendant care benefits, finding insufficient medical evidence of a complete inability to work and no evidence of incurred attendant care expenses.

As the applicant's non-catastrophic limits were exhausted, the claims for medical benefits and expenses were also dismissed.

The applicant sought a determination of catastrophic impairment following a motor vehicle accident.

The respondent scheduled psychological and occupational therapy insurer's examinations (IEs).

The applicant attended both, but the psychologist passed away before finalizing his report, and the applicant declined to participate in the situational portion of the occupational therapy IE.

The respondent scheduled a second set of IEs, which the applicant refused to attend.

The Tribunal found that a second in-person psychological IE was not reasonably necessary, as the respondent possessed the draft report and raw data.

However, the Tribunal found the situational occupational therapy assessment was reasonably necessary.

The Tribunal stayed the proceeding until the applicant complied with the situational assessment requirement.

The applicant was injured in a motor vehicle accident and sought various medical and rehabilitation benefits under the Statutory Accident Benefits Schedule for post-concussion syndrome and physical injuries.

The respondent insurer denied several treatment plans.

The Licence Appeal Tribunal found that the applicant was entitled to an in-home assessment, occupational therapy, a portion of a neuropsychological assessment, and assistive devices, as these were reasonable and necessary to address her cognitive and emotional symptoms.

However, claims for massage therapy, physiotherapy, and a rehabilitation support worker were dismissed because the applicant had reached maximum medical improvement from an orthopedic perspective and passive treatments provided only temporary relief.

The applicant was struck by a city bus as a pedestrian, sustaining soft tissue injuries and a mild traumatic brain injury.

She subsequently developed severe depression, anxiety, and post-traumatic stress disorder.

She applied for a determination that her impairments met the catastrophic threshold under the Statutory Accident Benefits Schedule.

The Tribunal found that while her cognitive complaints were largely psychogenic rather than organic, her psychological impairments were genuine and severely debilitating.

Relying on comprehensive neuropsychological and occupational therapy assessments, the Tribunal concluded the applicant suffered a marked impairment in the adaptation domain, thereby meeting the criteria for a catastrophic impairment under s. 2(1.2)(g) of the Schedule.