Ms. Shahla Kara

The applicant was struck by a vehicle while cycling and sought income replacement benefits (IRBs) under the Statutory Accident Benefits Schedule.

The respondent terminated pre-104 week IRBs on March 1, 2021, based on insurer's examinations.

The Tribunal found the applicant was not entitled to the remainder of the pre-104 week IRBs, as her ongoing post-concussive symptoms were attributable to a pre-accident sports injury rather than the subject accident.

However, the Tribunal found the applicant experienced a severe deterioration in her accident-related psychological conditions, culminating in a catastrophic impairment finding and multiple hospitalizations for suicidal ideation.

Applying the stringent post-104 week test, the Tribunal concluded the applicant suffered a complete inability to engage in any suitable employment as of April 11, 2023.

The applicant was awarded post-104 week IRBs from that date onward, plus interest.

The applicant sought a determination that she sustained a catastrophic impairment as a result of a 2021 motor vehicle accident, relying on Criterion 8 (mental and behavioural impairments).

The respondent denied the claim, arguing the impairments were moderate and partially pre-existing.

The Tribunal preferred the evidence of the applicant's experts, finding that the applicant suffered marked impairments in all four spheres of function (activities of daily living, social functioning, concentration/persistence/pace, and adaptation).

The Tribunal concluded the applicant sustained a catastrophic impairment as a direct result of the accident.

The applicant was involved in a motor vehicle accident and sought a determination that she sustained a catastrophic impairment due to a mental or behavioural disorder.

The respondent denied the claim, arguing her impairments were mild to moderate and complicated by other factors.

The Tribunal applied Chapter 14 of the AMA Guides and preferred the evidence of the applicant's experts, finding that the applicant's psychological and cognitive symptoms significantly impeded her useful functioning.

The Tribunal concluded that the applicant sustained a marked (Class 4) impairment in the domains of Concentration, Persistence and Pace, and Adaptation, thereby meeting the threshold for catastrophic impairment.