Dr. Richard Gladstone

The applicant sought a determination that she sustained a catastrophic impairment under Criterion 7 of the Statutory Accident Benefits Schedule following a motor vehicle accident.

The Tribunal assessed various Whole Person Impairment (WPI) ratings provided by multiple medical experts for physical and psychological impairments, including complex regional pain syndrome, sleep disturbances, and right upper extremity deficits.

The Tribunal rejected several of the applicant's expert ratings for failing to follow the AMA Guides' methodology and lacking objective medical evidence.

Ultimately, the Tribunal calculated a combined WPI rating of 50%, falling short of the 55% threshold required for a catastrophic impairment designation.

The application was dismissed.

The moving party sought court approval of a proposed $650,000 accident benefits settlement arising from a motor vehicle accident that caused catastrophic brain injury to the plaintiff as a child.

The court reviewed the medical evidence, future care needs, and the proposed allocation of settlement funds, including structured settlement arrangements and funds to be managed by the plaintiff’s mother.

The judge identified significant concerns regarding the adequacy of the settlement relative to future care needs, missing medical and economic reports, unclear accounting for certain funds, and the proposed guardianship and care arrangements.

The court concluded that the evidentiary record was insufficient to determine whether the settlement was in the plaintiff’s best interests.

The proposed settlement was therefore not approved and the matter was ordered to return with further evidence.

The applicant, a 62-year-old homemaker with a history of pre-existing depression and anxiety, was injured in a pedestrian knockdown.

She sought statutory accident benefits, including non-earner benefits, attendant care, housekeeping, prescription medication, and costs of examinations.

The arbitrator found that the accident significantly exacerbated her psychological condition, profoundly compromising her ability to engage in rewarding pre-accident activities such as babysitting, reading, and taking long walks.

Applying a qualitative approach to the non-earner benefit test, the arbitrator concluded she suffered a complete inability to carry on a normal life and awarded ongoing non-earner benefits and prescription medication costs.

Claims for attendant care and housekeeping were dismissed due to insufficient evidence.

The cost of a neurological assessment was allowed, but an orthopaedic assessment was denied as it did not address accident benefits.

A claim for a special award was also dismissed.

The insurer brought a motion seeking an order that the claimant attend a neurological and psychiatric assessment under s. 42(3) of the Statutory Accident Benefits Schedule, and for an adjournment of the upcoming arbitration hearing.

The claimant opposed, arguing the assessment was sought for evidentiary purposes rather than to adjust the file.

The arbitrator found that the insurer had been aware of the potential need for such assessments since 2002 but failed to request them until shortly before the hearing, and offered to cancel the assessment if the claimant abandoned her neuropsychological claims.

The arbitrator concluded the assessment was sought to bolster the insurer's case at arbitration and was not reasonably necessary.

The motion was dismissed, and the insurer was ordered to pay $500 in expenses.