John Lundrigan

The applicant sought a determination of catastrophic impairment under Criterion 8 of the Statutory Accident Benefits Schedule following a 2017 motor vehicle accident.

The respondent insurer denied the designation.

The Tribunal found that the applicant suffered marked impairments in three functional domains: Adaptation, Social Functioning, and Activities of Daily Living.

The adjudicator preferred the applicant's expert evidence, particularly an occupational therapy assessment that included community-based testing and collateral interviews, over the respondent's in-home assessment.

The Tribunal concluded that the applicant's severe psychological decline and alcohol use disorder were directly related to the accident, rendering him catastrophically impaired.

The applicant sought statutory accident benefits following a motor vehicle accident, specifically claiming $9,903.00 for dental treatment and $11,700.00 for a hot tub.

The Tribunal found the dental treatment was reasonable and necessary to repair accident-related damage, ordering payment with interest.

However, the claim for the hot tub was denied because the applicant incurred the expense prior to submitting the treatment plan, contrary to section 38(2) of the Schedule.

The Tribunal also declined to make an award for unreasonable delay, finding the insurer reasonably relied on its assessor's reports.

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, who sustained a catastrophic impairment in a 2000 automobile accident, applied for statutory accident benefits after being denied certain benefits by the respondent.

The matter proceeded to an in-person hearing before the Licence Appeal Tribunal.

At the hearing, the applicant withdrew his application, and the Tribunal closed the file.

The applicant suffered catastrophic injuries in a 2010 motorcycle accident and sought attendant care and housekeeping benefits.

The respondent insurer argued that the applicant's claims were subject to the definition of 'incurred expense' and the economic loss limitations for family care providers introduced in the SABS-2010 and its 2014 amendments.

The Tribunal held that because the accident occurred prior to September 1, 2010, the applicant's entitlement to and the quantum of benefits are governed by the 1996 Schedule.

The SABS-2010 definition of 'incurred expense' and its subsequent amendments limiting attendant care to the provider's economic loss do not apply retrospectively to this claim.

The applicant was injured in a motorcycle accident and sought statutory accident benefits from the insurer, claiming she suffered a catastrophic impairment due to a combination of physical injuries and severe psychological disorders (depression, PTSD, and chronic pain).

The arbitrator found that the applicant's combined physical and psychological impairments met the 55% whole person impairment threshold, qualifying her for catastrophic impairment status.

The arbitrator also found the applicant suffered a complete inability to carry on a normal life, entitling her to ongoing non-earner benefits.

Claims for a specialized hospital bed and certain rehabilitation expenses were granted, while claims for massage therapy, travel time, and a special award were denied.

The Member, a registered nurse, admitted to engaging in a sexual relationship with a psychiatric patient while employed at a hospital.

The Discipline Committee found the Member committed professional misconduct by sexually abusing the patient and violating professional boundaries.

The Member brought a Charter challenge, arguing that the mandatory revocation penalty discriminated against her on the basis of a mental disability.

The panel dismissed the Charter challenge, finding insufficient evidence that the Member suffered from a mental disability that affected her functioning at the time of the misconduct.

The panel ordered the mandatory penalty of revocation of the Member's certificate of registration and a reprimand.