Dr. Sangha

The applicant requested a reconsideration of a decision that dismissed her claims for catastrophic impairment and other benefits following a motor vehicle accident.

She argued the adjudicator made errors of law and fact and violated procedural fairness by misapprehending medical evidence and disregarding witness testimony.

The adjudicator dismissed the request, finding that while one minor factual omission occurred regarding the cause of the applicant's mobility issues, it would not have changed the outcome.

The adjudicator concluded that the original findings regarding the applicant's pre-existing conditions, credibility, and lack of accident-related impairments were supported by the evidence.

The applicant sought reconsideration of a decision finding he did not suffer a catastrophic impairment following a motor vehicle accident.

The applicant argued he was denied procedural fairness when his expert was prevented from expanding on answers during cross-examination and re-examination, and that the adjudicator misunderstood the expert's evidence regarding cauda equina-like syndrome.

The Vice Chair dismissed the request, finding that limiting re-examination correctly prevented the applicant from splitting his case.

Furthermore, while the adjudicator acknowledged a minor factual error regarding the AMA Guides, it was not material, as the expert's diagnosis was suspect due to his unawareness of the applicant's pre-existing severe degenerative disc disease.

The applicant sought a determination that he sustained a catastrophic impairment following a motor vehicle accident, which would entitle him to enhanced statutory accident benefits.

The central dispute involved whether the applicant's lower extremity symptoms were caused by accident-related damage to the cauda equina or by pre-existing degenerative disc disease.

The Tribunal preferred the respondent's medical evidence, finding that the applicant suffered an L1 fracture and that his ongoing symptoms were degenerative rather than accident-related.

As the applicant's Whole Person Impairment score did not reach the 55% threshold without the cauda equina impairment rating, the motion was dismissed.

The applicant sought a determination that he sustained a catastrophic impairment following a motor vehicle accident, which would entitle him to enhanced statutory accident benefits.

The dispute centered on whether his lower extremity symptoms were caused by accident-related damage to the cauda equina or pre-existing degenerative disc disease.

The tribunal accepted the respondent's medical evidence that the symptoms were degenerative and that treating physicians had ruled out cauda equina involvement.

Consequently, the applicant's Whole Person Impairment score did not meet the 55% threshold, and the application was dismissed.

The applicant sought a determination of catastrophic impairment and entitlement to various statutory accident benefits following a 2013 motor vehicle accident.

The respondent denied the benefits and sought repayment of income replacement benefits, alleging willful misrepresentation.

The Tribunal found that the applicant did not sustain a catastrophic impairment, as he failed to establish a 55% Whole Person Impairment or a Class 4 marked psychological impairment, preferring the respondent's medical experts over the applicant's.

Consequently, the claims for medical, attendant care, and housekeeping benefits were dismissed.

The Tribunal also dismissed the respondent's claim for repayment, finding insufficient evidence of fraud or willful misrepresentation by the applicant regarding his employment status.

The applicant was struck by a bus in 2012, sustaining multiple fractures and subsequent psychological impairments.

She applied for a determination of catastrophic impairment under two criteria of the Statutory Accident Benefits Schedule.

The Tribunal found that the applicant did not meet the 55% whole person impairment threshold under s. 3(2)(e), as her combined physical and psychological impairments rated between 42% and 46%.

However, the Tribunal concluded that the applicant was catastrophically impaired under s. 3(2)(f), finding she suffered a marked impairment in the functional areas of social functioning and adaptation due to her accident-related mental and behavioural disorders.

A claim for the cost of a psychiatric paper review was denied.

The applicant was injured in a motor vehicle accident and sought enhanced statutory accident benefits, claiming she suffered a catastrophic impairment.

The arbitrator found that the applicant sustained a catastrophic impairment under section 2(1.2)(g) of the Schedule, as she suffered a marked impairment in the area of adaptation due to a major depressive disorder.

The arbitrator preferred the evidence of the applicant's psychological expert over the insurer's expert, noting the former's comprehensive review of medical records and adherence to the AMA Guides.

The applicant was awarded ongoing income replacement benefits, having established a complete inability to engage in suitable employment due to chronic pain and medication side effects.

The arbitrator also awarded housekeeping benefits, specific periods of attendant care benefits, and approved several treatment plans.

A special award of 20% was ordered against the insurer for unreasonably delaying the assessment and payment of pre-104 week attendant care benefits following the applicant's surgery.