Nancy M McAuley

The applicant requested a reconsideration of a previous Tribunal decision that held him to the Minor Injury Guideline (MIG) and denied his treatment plans.

The Vice-Chair found that the original decision contained a factual error regarding the interpretation of a CT scan report, which did not rule out a concussion as previously concluded.

Upon re-hearing the matter, the Vice-Chair determined that the applicant's consistent neurological symptoms supported a concussion diagnosis, removing him from the MIG.

The applicant was awarded funding for physiotherapy, massage, and occupational therapy (excluding travel time), plus interest.

The claim for a special award was dismissed.

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

The insurer denied benefits and scheduled insurer's examinations under s. 44 of the Schedule.

The applicant refused to attend the examinations, arguing it was improper to schedule them after the Tribunal application had been filed.

The Tribunal found that the insurer had properly scheduled the examinations and that the applicant failed to provide a reasonable explanation for her non-attendance.

Consequently, pursuant to s. 55(1)2 of the Schedule, the applicant was barred from proceeding to a hearing, and the application was dismissed.

The applicant requested a reconsideration of a Licence Appeal Tribunal decision that found he was not catastrophically impaired under Criterion 8 of the Statutory Accident Benefits Schedule.

The applicant argued the adjudicator breached procedural fairness by providing inadequate reasons, displaying bias, and failing to address production order breaches, and that the adjudicator made errors of law and fact in assessing his psychological and social functioning impairments.

The Vice-Chair dismissed the request, finding the adjudicator provided clear and adequate reasons, no reasonable apprehension of bias was established, and the adjudicator's weighing of the expert evidence and application of the legal test for marked impairment were reasonable and free of error.

The applicant sought a determination that he sustained a catastrophic impairment under Criterion 8 of the Schedule and claimed entitlement to a post-104 income replacement benefit (IRB) following a motor vehicle accident.

The Tribunal found that the applicant did not meet the threshold for catastrophic impairment, as he did not demonstrate a marked impairment in at least two of the four functional domains, specifically finding his social functioning was compatible with some useful functioning.

However, the Tribunal granted the applicant's claim for a post-104 IRB, finding that the combination of his physical, psychological, cognitive, and visual impairments resulted in a complete inability to engage in any employment for which he was reasonably suited by education, training, or experience.

Interest was awarded on the overdue IRB payments.

The applicant was injured in a motor vehicle accident and received statutory accident benefits, including an income replacement benefit.

She also received a monthly disability benefit of $6,175.00 from a private RBC insurance policy.

The insurer sought to deduct the RBC benefit from the income replacement benefit under section 7 of the SABS.

The arbitrator held that the RBC policy met the criteria of an 'income continuation benefit plan' under section 2(9) of the SABS, as it was offered only to employed persons and the maximum benefit was calculated with reference to employment income.

Therefore, the RBC benefit was deductible.