Rod Hare

The applicant was injured in a motor vehicle accident and sought a determination of catastrophic impairment under the Statutory Accident Benefits Schedule.

The arbitrator found that the applicant sustained a catastrophic impairment under both the 55% whole person impairment (WPI) threshold (clause 2(1.2)(f)) and the marked impairment threshold for mental or behavioural disorders (clause 2(1.2)(g)).

The arbitrator accepted the applicant's physical impairment rating of 48% WPI and assessed her mental and behavioural impairment at 33% WPI, resulting in a combined 65% WPI.

The arbitrator also found a marked impairment in three of four functional spheres.

Regarding the claimed expenses totaling $83,417.90, the arbitrator awarded only $1,925.00 for a mental health assessment, dismissing the remainder because they were not properly submitted through the HCAI system as required by the Schedule.

The applicant was injured in a rear-end motor vehicle accident and sought payment for 99 active rehabilitation treatment sessions and four treatment plans.

The insurer denied the treatment plans, arguing the duration and cost were excessive.

The arbitrator found that the applicant required supervised active rehabilitation to return to his pre-accident heavy labour job and that the duration of the program was reasonable.

However, the arbitrator reduced the hourly rate from the claimed $150 to $60 per session, noting the treatment was provided in a group setting rather than one-on-one.

The arbitrator also awarded interest on overdue payments and a $1,000 special award, finding the insurer unreasonably withheld payments by unilaterally reducing the rate for approved treatment without a valid basis.

The applicant was struck by a vehicle and sustained a fractured tibia.

She sought statutory accident benefits for chiropractic and active rehabilitation therapy.

The insurer disputed the reasonableness of the treatment and the fees charged by the clinics.

The arbitrator found that the treatment was reasonable and necessary to assist in the applicant's recovery, but determined that the frequency and duration of the treatments, as well as the fees charged by the clinics, were excessive.

The arbitrator reduced the compensable sessions and the hourly rates, awarding $1,080.50 for chiropractic expenses and $635 for rehabilitation expenses, plus interest.