Dr. Rado

The applicant was seriously injured in a motor vehicle accident in Georgia and sought a determination that he sustained a catastrophic impairment under the Statutory Accident Benefits Schedule.

The parties' medical experts disagreed on the applicant's whole person impairment (WPI) rating, with the applicant's experts assessing it between 62% and 71%, and the insurer's experts assessing it between 48% and 51%.

The arbitrator preferred the evidence of the applicant's experts, finding that the applicant's physical and psychological impairments, when combined, exceeded the 55% threshold.

The arbitrator also found that the accident materially contributed to the applicant's impairments, including his atrial fibrillation and peripheral neuropathy, despite the insurer's arguments regarding pre-existing susceptibility.

The applicant was found to have sustained a catastrophic impairment.

The applicant was injured in a rear-end motor vehicle accident and received statutory accident benefits, including caregiver and housekeeping benefits, which were subsequently terminated by the insurer.

The applicant sought ongoing caregiver benefits, housekeeping expenses, and the cost of medical reports.

The arbitrator found the applicant's testimony regarding her pre-accident and post-accident activity levels to be vague and contradictory, and noted inconsistencies with surveillance evidence.

Consequently, the arbitrator concluded that the applicant failed to establish on a balance of probabilities that she suffered a substantial inability to engage in caregiving activities or a partial inability to carry on a normal life.

The medical opinions were also deemed unreliable as they were based on the applicant's unreliable self-reporting.

The application for ongoing benefits was dismissed.