Sherry Mosher Taillefer

The applicant sought statutory accident benefits for physiotherapy, in-home yoga therapy, assistive devices, and handrails following a motor vehicle accident.

The insurer denied the benefits.

The Tribunal found that the applicant's accident-related physical injuries had largely resolved and that her ongoing pain was due to non-accident-related conditions such as arthritis and fibromyalgia.

The Tribunal also found insufficient evidence to link her balance issues and need for assistive devices to the accident.

The application was dismissed in its entirety.

The applicant, who was deemed catastrophically impaired following a 2014 motor vehicle accident, sought payment for several treatment plans under the Statutory Accident Benefits Schedule.

The Tribunal denied the treatment plans for a sleep system and a scuba diving course, finding they were not reasonable and necessary as the applicant had a similar sleep system prior to the accident and was already engaging in other activities that supplanted the need for the scuba course.

However, the Tribunal approved the treatment plan for a rehabilitation assistant to help the applicant move homes, noting his physical and psychological impairments hindered his ability to do so independently.

The Tribunal also approved treatment plans for chiropractic, massage, and physiotherapy services, finding they provided necessary pain relief, but denied a duplicate chiropractic plan.

The applicant sought statutory accident benefits following a 2018 motor vehicle accident, claiming catastrophic impairment due to psychological injuries, non-earner benefits, treatment plans, and education expenses.

The Licence Appeal Tribunal found the applicant was not catastrophically impaired, preferring the respondent's psychiatric assessment which properly accounted for her significant pre-existing mental health conditions and post-accident stressors.

Claims for non-earner benefits and treatment plans were dismissed as the applicant failed to prove a complete inability to carry on a normal life or the reasonableness and necessity of the plans.

The Tribunal granted the claim for education expenses, finding the applicant was unable to continue her college program due to the accident.

The applicant sought a determination of catastrophic impairment (CAT) under criterion 8 of the Statutory Accident Benefits Schedule following a motor vehicle accident.

The respondent denied the CAT designation, arguing the applicant's impairments were caused by pre-existing conditions and prior accidents.

The Tribunal applied the "but for" test and found the accident caused the applicant's psychological impairments, including somatic symptom disorder.

The Tribunal concluded the applicant suffered a marked impairment in activities of daily living, concentration, persistence and pace, and adaptation, thereby meeting the CAT threshold.

However, the applicant's claims for travel expenses for his daughter's flight and out-of-town CAT assessments were dismissed for lack of evidence establishing they were reasonable and necessary.

The claim for an award under s. 10 of Regulation 664 was also dismissed.

The applicant sought a determination that she sustained a catastrophic impairment due to mental or behavioural disorders following a motor vehicle accident.

The Tribunal found that the applicant failed to prove a marked impairment in the adaptation domain.

The Tribunal placed limited weight on the applicant's experts because the applicant had concealed significant functional activities, such as independently driving to Nova Scotia and planning a wedding, and because her psychiatrist strayed into advocacy.

The application was dismissed, and no award for unreasonable delay was granted.

The Tribunal also ordered the applicant's name initialized to protect her safety as a survivor of intimate partner violence.

The applicant, catastrophically impaired following a bus-train collision, sought statutory accident benefits for home modifications, the purchase of a new home, and housekeeping services.

The Tribunal deemed the $166,437.70 home modification expense incurred under s. 3(8) of the Schedule due to the insurer's unreasonable delay and flawed reliance on its assessors, awarding a 25% special award.

The request for $839,104.50 to purchase a new home was dismissed as it exceeded the value of necessary home modifications under s. 16(4)(c).

Housekeeping benefits of $100 per week were granted from February 2019 onwards.

The insurer was found entitled to repayment of an $8,747.42 overpayment of income replacement benefits resulting from a failure to recalculate the benefit when the applicant turned 65.

The applicant was injured in a motor vehicle accident and sought a determination of catastrophic impairment based on mental or behavioural disorders (Criterion 8).

The applicant suffered a severe breast injury resulting in chronic pain, which she argued caused marked impairments in social functioning and adaptation.

The arbitrator applied the AMA Guides and found that while the applicant suffered from mental disorders, her impairments in social functioning and adaptation were at most moderate (Class 3).

The arbitrator concluded that the applicant's work challenges stemmed primarily from physical pain rather than a mental disorder, and dismissed the application for catastrophic impairment.