Tracie Shaw

The applicant sought a determination that she sustained a catastrophic impairment due to mental and behavioural disorders following a motor vehicle accident, as well as entitlement to various treatment plans and an award for unreasonable delay.

The Tribunal found that the applicant did not sustain a catastrophic impairment, as she failed to prove a marked impairment in three of the four areas of function under Criterion 8 of the AMA Guides.

The Tribunal preferred the evidence of the respondent's psychiatrist, noting the applicant's significant pre-existing physical and mental impairments.

Several treatment plans for psychological and chronic pain assessments were approved as reasonable and necessary, subject to the non-catastrophic limit, while others were denied.

The claim for a special award was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming she sustained a catastrophic impairment under Criterion 8 of the Schedule.

The Tribunal found the applicant's expert evidence persuasive, concluding she suffered a Class 4 (Marked) Impairment in all four domains of function due to psychological and somatic symptom disorders.

The respondent's expert evidence was given little weight due to critical errors.

However, the Tribunal dismissed the applicant's claims for various treatment plans and assessments, finding she failed to provide sufficient evidence or identify the goals to prove they were reasonable and necessary.

The applicant, who sustained a catastrophic impairment in a 2000 motor vehicle accident, sought various medical and rehabilitation benefits under the Statutory Accident Benefits Schedule.

The Licence Appeal Tribunal found that treatment plans for massage therapy, physiotherapy, aqua therapy, and a hot tub were reasonable and necessary to address the applicant's chronic pain.

However, claims for a Costco membership, private pool therapy, a rehabilitation support worker, and occupational therapy were dismissed as the applicant failed to prove they were reasonable and necessary.

The Tribunal also denied the applicant's request for a special award under s. 10 of Regulation 664, finding that the insurer did not unreasonably withhold or delay benefits by relying on its s. 44 assessments.

The applicants, who both required leg amputations following a motorcycle accident, sought funding for home modifications under the Statutory Accident Benefits Schedule.

The parties presented competing modification plans, with the applicants proposing a one-storey expansion and the respondent proposing a two-storey build.

The adjudicator found the applicants' plan to be reasonable and necessary, as it accommodated their wheelchair needs while preserving their pre-accident lifestyle and avoiding the safety risks of a two-storey design.

The adjudicator also awarded the applicants 25% of the value of a back-up generator under section 10 of Regulation 664, finding that the respondent unreasonably delayed its approval.

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

The Tribunal applied the Pastore three-step approach and assessed the applicant's functioning in four domains.

Relying on surveillance evidence and the respondent's expert assessments, the Tribunal found the applicant sustained only mild to moderate impairments in the four domains.

The application was dismissed as the applicant failed to meet the threshold for catastrophic impairment.

The applicant was injured in a motorcycle accident and sought a determination that he sustained a catastrophic impairment, along with claims for attendant care benefits and a special award.

The arbitrator evaluated competing medical assessments and preferred the insurer's experts, finding the applicant's combined physical and psychological impairments amounted to 49% Whole Person Impairment, falling short of the 55% threshold.

The claim for attendant care benefits was dismissed as the applicant failed to demonstrate an economic loss incurred by his wife and medical assessments indicated he was independent in self-care.

The request for a special award was denied because the insurer had not unreasonably withheld benefits.

The applicant was ordered to pay the insurer's hearing expenses.