Julie Kern

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 requested reconsideration of a Licence Appeal Tribunal decision that found she was not catastrophically impaired and denied her treatment plans.

The applicant argued the adjudicator committed a material breach of procedural fairness by providing insufficient reasons.

The Vice-Chair agreed, finding the original decision lacked a comprehensive explanation for preferring the respondent's expert evidence and concluding the applicant had reached maximum medical recovery.

The reconsideration request was granted, the original decision was cancelled, and a rehearing based on the existing record was ordered to accommodate the applicant's vulnerability.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming she sustained a catastrophic impairment under Criterion 8 of the Schedule due to marked impairments in Adaptation, Activities of Daily Living, and Concentration, Persistence and Pace.

The adjudicator preferred the respondent's expert evidence, finding that the applicant's psychological testing was invalid due to negative response bias and that she did not suffer from cognitive impairments or struggle with daily tasks.

The adjudicator concluded the applicant was not catastrophically impaired, had reached maximum medical recovery, and was not entitled to the disputed treatment plans, assessments, interest, or a special award.