Maia Bent

The applicant requested a reconsideration of a previous Licence Appeal Tribunal decision that denied her entitlement to a treatment plan for vestibular physiotherapy.

The applicant argued the Tribunal erred in law by applying the incorrect legal test for res judicata.

The Adjudicator agreed, finding that the previous decision relied on an incorrect four-part test rather than the binding three-part test from the Supreme Court of Canada, and failed to properly analyze whether the same issue had been previously decided.

Upon reconsidering the merits, the Adjudicator found the applicant was partially entitled to the treatment plan in the amount of $2,697.28, as the treatment was reasonable and necessary for her accident-related post-concussion symptoms, though costs incurred prior to the plan's submission were excluded under s. 38(2) of the Schedule.

The applicant sought statutory accident benefits following a 2018 motor vehicle accident.

The Licence Appeal Tribunal found the applicant was entitled to $2,700 for social work services and various expenses for medical cannabis, preferring the evidence of her treating practitioners over the insurer's assessors.

However, the Tribunal dismissed claims for case management services and a Cefaly device for lack of supporting medical evidence.

A claim for vestibular physiotherapy was dismissed as barred by res judicata, as it had been denied in a previous Tribunal decision and the applicant's new evidence did not conclusively impeach the original result.

The applicant sought a preliminary order deeming him catastrophically impaired under Criterion 7 of the Statutory Accident Benefits Schedule, relying on a section 44 insurer examination by Dr. Waseem that concluded he met the 55% Whole Person Impairment threshold.

The respondent insurer opposed the motion, relying on conflicting section 44 assessments and an executive summary that concluded the applicant's wheelchair dependency was caused by pre-existing diabetes complications rather than the accident.

The Tribunal dismissed the applicant's request, holding that an insurer is not bound by the opinion of a single section 44 assessor and that a full hearing was required to weigh the complex medical evidence regarding causation.

The Tribunal also ordered the applicant to attend a section 44 psychiatric examination before proceeding with the application.

The Applicant was catastrophically injured in a motor vehicle accident and received supplementary attendant care services from her parents and a hospital.

No Form 1 was completed at the time.

Years later, an occupational therapist completed a retroactive Form 1.

The Insurer refused to pay, arguing a Form 1 cannot be retroactive and the expenses were not incurred.

The Arbitrator held that the Schedule does not prohibit a retroactive Form 1 and that the services provided by family and the hospital were 'incurred'.

The Insurer was ordered to pay the attendant care benefits, the cost of the Form 1, interest, and expenses.

The applicant was injured in a motor vehicle accident and applied for a determination of catastrophic impairment based on a Glasgow Coma Scale (GCS) score of 8.

The insurer denied the application, relying on an expert who opined that the score was invalid due to intubation and medications administered for surgery.

The arbitrator rejected the expert's opinion, finding that the expert ignored medical records showing the applicant was no longer intubated and that the medications would have cleared her system before the test.

The arbitrator concluded the GCS score was valid, accurate, and administered within a reasonable period of time, and therefore the applicant sustained a catastrophic impairment.