Shaynee Mehta

The applicant was catastrophically impaired in a snowmobile accident and sought payment for the outstanding balances of treatment plans for home modifications and a neuropsychological assessment.

The applicant argued that the remaining balance for home modifications should be deemed incurred because the respondent unreasonably withheld payment.

The Tribunal found that the respondent had paid all submitted land, construction, and building expenses for the applicant's new home, and the applicant was not entitled to the outstanding balance of the original home modification estimate.

The Tribunal also found that a comprehensive file review is an inherent component of an assessment and is subject to the $2,000 fee limit under s. 25(5) of the Schedule.

The application was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, including non-earner benefits, chiropractic services, and a psychological assessment.

The Licence Appeal Tribunal denied the non-earner benefits, finding the applicant was able to carry on a normal life and had pre-existing conditions.

The psychological assessment was also denied based on a section 44 assessment showing no psychological impairment.

However, the Tribunal approved the chiropractic services treatment plan, finding it reasonable and necessary.

The Tribunal also granted a section 10 award of 50% of the chiropractic benefits, finding the insurer unreasonably withheld payment by relying on a section 44 assessment that it knew would deny the claim based on minor injury guidelines, despite the applicant not being confined to those guidelines.

The applicant sought a determination that he sustained a catastrophic impairment following a motor vehicle accident, along with entitlement to treatment plans for assistive devices and a mental/behavioural assessment.

The Tribunal assessed the applicant's whole person impairment (WPI) rating, weighing competing expert evidence on psychological impairment, neurogenic bladder, sexual dysfunction, and upper extremity impairment.

The Tribunal found a total WPI rating of 52%, falling short of the 55% threshold required for catastrophic impairment.

The Tribunal partially approved the treatment plan for assistive devices, granting funding for a bed, mattress, pillow, and related occupational therapy services, but denied the mental/behavioural assessment and a claim for a special award.

Interest was awarded on the overdue benefits.

The applicant sought various statutory accident benefits following a motor vehicle accident, including increased attendant care benefits, multiple treatment plans, and expenses for eyeglasses.

The Licence Appeal Tribunal dismissed all claims.

The Tribunal found the applicant failed to provide evidence of incurred past attendant care expenses and preferred the respondent's occupational therapy assessment for ongoing care, concluding that 24/7 care was not justified.

The claims for treatment plans and assessments were dismissed due to a complete lack of supporting evidence, and the claims for eyeglasses were denied because the expenses had not been incurred.