Darcy R. Merkur

The applicant sought statutory accident benefits for home modifications totaling $777,467.00 following a motor vehicle accident that resulted in a spinal cord injury.

Prior to the submission of the treatment plan, the applicant's family sold their pre-accident home and purchased a new bungalow.

The Tribunal found that the proposed modifications were for a home the applicant no longer resided in, and no assessment was provided for the new bungalow.

The Tribunal dismissed the application, concluding the applicant failed to prove the modifications were reasonable and necessary, and denied claims for interest and a special award.

The applicant requested a reconsideration of a Tribunal decision finding that she was not entitled to case management services under s. 17(1)(b) of the Statutory Accident Benefits Schedule.

The applicant argued that purchasing the optional catastrophic impairment benefit under s. 28(1)5 was sufficient to trigger entitlement, even without a catastrophic impairment designation.

The Associate Chair confirmed the Tribunal's decision, applying principles of statutory interpretation to conclude that the optional benefit is only 'available' if the insured person actually sustains a catastrophic impairment.

The applicant sought case management services following a motor vehicle accident, relying on the purchase of an optional catastrophic impairment benefit under s. 28(1) 5 of the Statutory Accident Benefits Schedule.

The applicant had not been deemed catastrophically impaired.

The Licence Appeal Tribunal held that the plain language of s. 17(1)(b) read with s. 28(1) 5 requires both the purchase of the optional benefit and a catastrophic impairment designation to trigger entitlement to case management services.

The preliminary issue was resolved in favour of the respondent.