Loreta Stanulis-Duz

The applicant sought a determination of catastrophic impairment and entitlement to income replacement benefits (IRB), attendant care benefits (ACB), and various treatment plans following a 2018 motor vehicle accident.

The Tribunal found the applicant did not meet the 55% whole person impairment threshold under Criterion 7, concluding his combined physical and mental impairment rating was 40%.

The Tribunal also found the applicant failed to prove a complete inability to engage in suitable employment, dismissing the claim for post-104-week IRB.

As the applicant was not catastrophically impaired and had exhausted non-catastrophic limits, the claims for ACB and treatment plans were also dismissed.

The applicant was injured in a rear-end motor vehicle collision and sought statutory accident benefits.

The respondent insurer denied further treatment and non-earner benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant's injuries fell outside the MIG due to chronic pain syndrome, relying on the applicant's credible testimony and the evidence of a chronic pain specialist.

Applying the Heath framework, the Tribunal also found the applicant suffered a complete inability to carry on a normal life and awarded non-earner benefits.

The disputed treatment plans for physiotherapy and a chronic pain assessment were deemed reasonable and necessary and were approved with interest.

The applicant, who sustained catastrophic injuries as a pedestrian struck by a truck, sought attendant care benefits of $6,000 per month and various treatment plans.

At the outset of the hearing, the applicant brought a motion seeking the adjudicator's recusal based on an alleged reasonable apprehension of bias, citing the adjudicator's past decision record.

The Tribunal dismissed the recusal motion, finding the statistical analysis unverified and insufficient to overcome the presumption of impartiality.

On the merits, the Tribunal found that the applicant failed to prove she had incurred attendant care expenses beyond what the insurer had already paid.

The Tribunal also declined to deem the expenses incurred under s. 3(8) of the Schedule, finding the insurer had not unreasonably withheld or delayed payments.

The applicant's claims were dismissed, and costs of $500 were awarded to the respondent for unreasonable motions brought by the applicant.

The applicant sought various statutory accident benefits following a motor vehicle accident, including attendant care benefits, medical benefits, and an award for unreasonable delay.

The adjudicator found that the applicant was not entitled to attendant care benefits, orthotics, an orthopaedic assessment, or a Functional Abilities Evaluation, as they were not proven to be reasonable and necessary.

However, the applicant was awarded the balance of a psychological assessment and medication expenses.

Additionally, the adjudicator found that the respondent failed to provide proper notice under s. 38(8) of the Schedule for a chiropractic treatment plan, making the respondent liable for incurred costs during the period of non-compliance.

The claim for an award under Regulation 664 was dismissed.

The applicant sought non-earner benefits following a motor vehicle accident, claiming his soft tissue injuries and headaches prevented him from engaging in his pre-accident activities, including camping, hunting, fishing, and volunteering.

The respondent denied the benefits based on insurer examinations.

The Tribunal applied the Heath framework and found the applicant credible, noting that his pre-existing conditions made him more susceptible to functional impairment from the accident.

The Tribunal gave little weight to the respondent's medical expert who claimed the applicant could perform all pre-accident activities, as the expert failed to list those activities or account for the pre-existing conditions.

The Tribunal concluded the applicant suffered a complete inability to carry on a normal life and awarded non-earner benefits and interest, but dismissed the claim for a special award under Regulation 664.

The applicant sought ongoing income replacement benefits, housekeeping benefits, and a catastrophic impairment designation following a 2007 motor vehicle accident.

The arbitrator dismissed all of the applicant's claims, finding her to be an unreliable and evasive witness whose testimony was contradicted by surveillance video, medical records, and her own prior statements.

Because the applicant's subjective reports were deemed not credible, the medical evidence relying on those reports was also rejected.

The applicant was ordered to pay $40,000 in arbitration expenses to the insurer.