Sherry Krushed

The insurer appealed and the claimant cross-appealed an Arbitrator's decision regarding attendant care benefits (ACBs) and a special award for unreasonably withheld income replacement benefits (IRBs) following a motor vehicle accident.

The Director's Delegate corrected mathematical and rate errors in the Arbitrator's ACB calculation, increasing the monthly amount to $1,615.32.

The Delegate upheld the Arbitrator's factual finding that the claimant did not require 24-hour supervisory care, preferring the insurer's occupational therapy evidence over the claimant's assessor, who was found to lack objectivity.

The Delegate also held that section 39(3) of the SABS does not bar retroactive ACB claims, as it governs the timing of payment rather than entitlement.

The insurer's appeal against the special award was dismissed, as evidence supported the finding that IRBs were unreasonably withheld.

The applicant, a registered nurse, was struck by a school bus and claimed catastrophic impairment due to physical, cognitive, and psychological injuries.

The insurer disputed the catastrophic designation and denied ongoing attendant care and housekeeping benefits.

The arbitrator found the applicant sustained a catastrophic impairment under both the marked mental/behavioural impairment threshold and the 55% whole person impairment threshold, preferring the evidence of the applicant's experts who properly accounted for her severe depression and chronic pain.

The arbitrator awarded ongoing attendant care, housekeeping benefits, the cost of a cellphone, and a special award due to the insurer's unreasonable delay in reinstating income replacement benefits.