Dr. Mascarenhas

The applicant sought a determination of catastrophic impairment and entitlement to various treatment plans following a motor vehicle accident.

The Tribunal found that the applicant did not meet the 55% whole person impairment threshold under either Criterion 6 (physical) or Criterion 7 (combined physical and psychological), assessing his physical impairment at 37% and combined impairment at 43%.

The Tribunal denied the claim for outstanding catastrophic impairment assessments, finding them duplicative.

However, the Tribunal granted the cost of a NuStep cross trainer, finding it reasonable and necessary for the applicant's rehabilitation.

The Tribunal also granted the cost of a neurovisual assessment because the insurer's denial notice failed to comply with the requirements of s. 38(8) of the Schedule.

The applicant's request for costs was dismissed.

The applicant sought accident benefits following a motor vehicle accident.

The insurer denied the claims on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued that her injuries, including drop attacks, a knee injury, chronic pain, and psychological issues, removed her from the MIG.

The Tribunal found that the applicant failed to establish on a balance of probabilities that her drop attacks and knee injury were caused by the accident, applying the 'but for' test.

Furthermore, the applicant did not provide compelling evidence of a pre-existing psychological condition that would prevent maximal recovery.

As the applicant's injuries were predominantly minor and she had exhausted the $3,500 MIG limit, her claims for further chiropractic services and interest were dismissed.

The applicant sought statutory accident benefits for chiropractic treatment and a chronic pain assessment following a motor vehicle accident.

The respondent denied the benefits, arguing the injuries fell within the Minor Injury Guideline and that a subsequent accident caused the chronic pain.

The Tribunal dismissed the application, finding one treatment plan was statute-barred as it was appealed beyond the two-year limitation period without justification for an extension.

The Tribunal further held the remaining chiropractic plans were not reasonable and necessary, as previous similar treatments had been ineffective and the applicant failed to prove his impairments extended beyond minor soft tissue injuries.

Finally, the request for a chronic pain assessment was denied because the applicant failed to establish causation linking the chronic pain to the first accident rather than the second.

The applicant sought accident benefits following a motor vehicle accident, including non-earner and medical benefits.

At the outset of the hearing, the applicant terminated his paralegal's representation and proceeded self-represented.

The applicant failed to produce required documentation or call witnesses to support his claims.

The insurer's medical expert testified that the applicant sustained only minor strains requiring limited treatment and had no functional limitations.

The arbitrator accepted the expert's evidence, which the applicant conceded was accurate, and found the injuries fell within the Minor Injury Guideline.

The application was dismissed, and the insurer was awarded $4,000 in expenses.

Following an arbitration where the applicant's claims for statutory accident benefits were dismissed, the insurer sought its expenses of approximately $35,000.

The arbitrator declined to order the applicant's counsel to personally pay the expenses, finding no evidence of frivolous claims or unreasonable delay attributable to counsel.

The arbitrator found the insurer was entitled to its expenses from the applicant as the successful party.

However, the arbitrator reduced the claimed fees and disbursements, noting the case was not particularly complex and disallowing costs for transcripts and excessive expert preparation time.

The applicant was ordered to pay $15,000 in expenses to the insurer.

The applicant sought statutory accident benefits following a motor vehicle accident, including medical benefits and income replacement benefits (IRBs).

The insurer denied the claims on the basis that the applicant's impairments fell within the Minor Injury Guideline (MIG) and that he did not meet the disability test for IRBs.

The arbitrator dismissed all of the applicant's claims, finding significant credibility issues due to inconsistent reporting of pre-accident medical history, post-accident employment, and income.

The arbitrator concluded that the applicant's impairments were predominantly minor injuries and that he failed to prove a substantial inability to perform the essential tasks of his pre-accident employment, noting that he had worked in physically demanding jobs post-accident.

The applicant was injured in a motor vehicle accident and received income replacement benefits until the insurer terminated them based on medical assessments indicating he could return to his pre-accident employment as a machine operator.

The arbitrator found that the insurer's assessments relied on a flawed ergonomic report that incorrectly classified the applicant's job as sedentary to light.

The arbitrator accepted the applicant's evidence that his job required significant standing, bending, and lifting, which he could no longer perform for a full shift due to ongoing knee pain and swelling.

The applicant was awarded ongoing income replacement benefits and supplementary medical benefits for physiotherapy, while the insurer's claims for repayment and a special award were dismissed.

The applicant, a 70-year-old pedestrian, was struck by a vehicle and sustained orthopaedic injuries.

She sought statutory accident benefits for attendant care and other services provided by her daughter.

The insurer disputed the quantum and causation, arguing the applicant's progressive dementia was not accident-related.

The arbitrator found the dementia was not caused by the accident but awarded attendant care and housekeeping benefits based on the applicant's accident-related orthopaedic impairments, increasing from 7 to 14 hours per week over time, payable at the minimum wage rate.

Claims for a special award were dismissed due to the applicant's misrepresentations regarding her daughter's lost income.

The appellant appealed an arbitrator's decision denying him continued weekly benefits, care benefits, and medical and rehabilitation benefits following a motor vehicle accident.

The appellant, who represented himself, alleged fraud and misconduct by the insurer and its representatives.

The Director's Delegate found no merit in the fraud allegations and upheld the arbitrator's finding that the appellant was no longer substantially unable to perform his essential tasks by February 1994, relying in part on the testimony of the appellant's own family doctor.

The appeal was dismissed, and the appellant was ordered to pay the insurer's assessment fee of $500 for advancing vexatious allegations and abusing the Commission's process.

The applicant was injured in a motor vehicle accident and received statutory accident benefits from the insurer until they were terminated.

She applied for arbitration claiming ongoing weekly income benefits, medical expenses, and a special award.

The arbitrator found that the applicant suffered a substantial inability to perform the essential tasks of her employment as a dispatcher/cashier due to ongoing physical and psychological injuries, including right arm weakness, anxiety, and depression caused by the accident.

The arbitrator awarded weekly income benefits for the disputed two-year period.

Claims for nutritional counselling, meal replacements, and a special award were dismissed due to insufficient evidence.

The arbitrator also ruled that the new expense provisions under the Automobile Insurance Rate Stability Act did not apply retroactively, denying the insurer's claim for expenses and awarding the applicant her expenses of the proceeding.

The applicant was injured in a motor vehicle accident and received statutory accident benefits as an unemployed person.

He subsequently claimed he had a valid offer of employment at the time of the accident and should receive higher benefits under section 12 of the Statutory Accident Benefits Schedule.

The insurer terminated his benefits entirely on June 17, 1994, arguing he was no longer substantially unable to perform his essential tasks.

The arbitrator found that the applicant did not have a legitimate pre-accident offer of employment.

Relying on medical reports and surveillance video showing the applicant driving and assisting passengers, the arbitrator concluded the applicant could perform his essential tasks and upheld the termination of benefits.

The arbitrator also found the applicant's subsequent shoulder dislocation was not caused by the accident.

The applicant was awarded his arbitration expenses.