Dr. Robert Hastings

The applicant was injured in a severe motor vehicle accident and sought a determination that she sustained a catastrophic impairment under criterion 7 of the Statutory Accident Benefits Schedule.

The applicant claimed a combined whole person impairment (WPI) of 55%, relying on various physical and psychological assessments.

The respondent argued the WPI was 35%.

The Tribunal evaluated the competing expert medical evidence regarding the applicant's spinal impairments, scarring, headaches, vertigo, and psychological functioning.

Ultimately, the Tribunal preferred the respondent's experts on several key issues, concluding that the applicant's combined WPI was 50%.

As this fell short of the 55% threshold, the application was dismissed.

The applicant was involved in a motor vehicle accident and sought a determination of catastrophic impairment and entitlement to various statutory accident benefits.

The Licence Appeal Tribunal found that the applicant sustained a catastrophic impairment under both Criterion 6 (64% whole person impairment) and Criterion 2 (severe and permanent alteration of lower extremities with a SCIM score of 4).

The Tribunal awarded incurred attendant care benefits from October 2021 to March 2022 but denied ongoing attendant care benefits as the applicant failed to provide an updated Form 1 reflecting her current needs.

Claims for four specific treatment plans were dismissed as the applicant provided no evidence to support them.

Interest was awarded on all overdue payments.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming catastrophic impairment under Criteria 6 and 7 of the Schedule.

The Tribunal found the applicant did not meet the 55% whole person impairment threshold, preferring the respondent's medical experts who assessed a 25% combined impairment over the applicant's experts whose ratings were unsupported by the AMA Guides.

The Tribunal also dismissed claims for income replacement benefits, attendant care benefits, and various treatment plans due to a lack of supporting evidence.

The respondent's claim for repayment of income replacement benefits was also dismissed for lack of evidence.

The applicant sought income replacement benefits (IRBs) following a motor vehicle accident, claiming she was unable to work as a self-employed aesthetician.

The respondent insurer denied the benefits based on section 44 assessments and sought repayment of a $557.50 overpayment.

The Tribunal found the applicant failed to provide contemporaneous medical evidence proving a substantial or complete inability to perform the essential tasks of her employment.

The applicant's claim for IRBs, interest, and a special award was dismissed.

The respondent's request for repayment was granted, as the overpayment was an error and timely notice was provided.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent denied portions of a treatment plan for catastrophic impairment assessments and suspended income replacement benefits due to the applicant's non-attendance at an assessment.

The Tribunal found the mental/behavioural assessment was reasonable and necessary, awarding its cost and associated HST, but denied the cost of a comprehensive file review as a duplication of services.

The Tribunal also found the applicant provided a reasonable explanation for missing the assessment due to illness, making the suspended income replacement benefits overdue and subject to interest.

An award of $370 was granted against the respondent for unreasonably withholding the benefits despite the explanation.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming costs for physiotherapy, a physiatry assessment, and a psychological assessment.

The adjudicator found the physiotherapy treatment plan reasonable and necessary as the applicant reported gradual improvement and pain relief.

The physiatry assessment was also approved, supported by medical opinions indicating the applicant suffered from chronic pain syndrome extending beyond the expected recovery period.

However, the claim for a psychological assessment was dismissed because there was insufficient documented evidence of psychological impairments in the family physician's records, and the respondent's psychological assessment finding no impairment was preferred.

Interest was awarded on the overdue payments for the approved benefits.

The applicant sought statutory accident benefits following a rear-end motor vehicle collision.

The respondent denied several treatment plans for physiotherapy, psychological services, and physiatry assessments on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant suffered soft tissue injuries and did not establish that pre-existing conditions, chronic pain with functional impairment, or psychological impairments warranted removal from the MIG.

As the $3,500 MIG limit was exhausted, the disputed treatment plans were not payable.

The application was dismissed.