Dr. Paul Mendella

The applicant was injured in a motor vehicle accident and sought a catastrophic impairment designation under the Statutory Accident Benefits Schedule due to a mental or behavioural disorder.

The respondent insurer denied the designation.

The Tribunal found that the applicant suffered a Class 4 (marked) impairment in the domains of activities of daily living and adaptation to work or worklike settings, caused by an accident-related Somatic Symptom Disorder.

The Tribunal concluded the applicant was catastrophically impaired effective October 19, 2016.

The plaintiff pedestrian was struck by the defendant's vehicle while crossing a street.

The defendant was found 100% liable.

The plaintiff had a highly complex pre-existing medical history, including chronic pain, sarcoidosis, and melanoma.

The court found the plaintiff suffered a mild traumatic brain injury and other injuries from the collision, which exacerbated his pre-existing conditions and impaired his ability to manage them.

The court assessed damages for the plaintiff and his family members, but reduced the total awards by 25% applying the crumbling skull principle, as the plaintiff would have been detrimentally affected by his pre-existing conditions regardless of the accident.

The injuries were found to meet the statutory threshold.

The applicant was injured in a rear-end motor vehicle accident and sought income replacement benefits (IRBs) and medical benefits from his insurer.

The insurer denied the benefits, arguing that the applicant's inability to work was caused by pre-existing psychological issues and not the accident.

The arbitrator applied the 'material contribution' test for causation and found that the accident materially contributed to the applicant's post-concussion syndrome, depression, and resulting unemployability.

The arbitrator awarded IRBs for both the pre-104-week and post-104-week periods, relying heavily on undisputed vocational expert testimony that the applicant was completely unemployable.

The arbitrator also awarded the claimed medical benefits and ordered the insurer to pay a special award of $30,000, finding that the insurer acted unreasonably in continuing to deny benefits despite overwhelming evidence of the applicant's accident-related impairments.