The applicant sought a determination that she sustained a catastrophic impairment under Criterion 8 (mental or behavioural disorder) as a result of a motor vehicle accident, as well as payment for the unapproved balance of a catastrophic assessment treatment plan.
The respondent brought a preliminary motion arguing the claim was barred by res judicata due to a prior Tribunal decision denying non-earner benefits.
The adjudicator dismissed the motion, finding the prior decision did not rule on psychological impairments.
On the merits, the adjudicator found the applicant was not catastrophically impaired, preferring the respondent's psychiatric evidence that the applicant's impairments were pre-existing from a 2019 accident and that she had returned to her premorbid baseline.
Surveillance evidence and the applicant's ongoing activities, including attending college and travelling, contradicted claims of marked impairment.
The claim for the unapproved treatment plan balance was also dismissed as the applicant failed to justify costs exceeding the statutory maximums.
