Ontario Insurance Commission
Neutral Citation: 1997 ONICDRG 158 File No.: OIC A95-000263
Between:
Ramon Riviezzi Applicant
and
Markel Insurance Company of Canada Insurer
DECISION
Issues:
The Applicant, Ramon Riviezzi, claims he was injured in a motor vehicle accident on February 28, 1994. He applied for and received statutory accident benefits from Markel Insurance Company of Canada ("Markel"), payable under the Schedule.1 Markel stopped paying Mr. Riviezzi weekly benefits on October 30, 1994. The parties were unable to resolve their disputes through mediation and Mr. Riviezzi applied for arbitration under the Insurance Act, R.S.O. 1990, c.I.8, as amended.
The issues in this hearing are:
Is Mr. Riviezzi entitled to benefits after October 30, 1994?
If Mr. Riviezzi is entitled to benefits, should he receive "other disability benefits" under section 19 of the Schedule, or "education disability benefits" under section 15?
Mr. Riviezzi also claims interest on any amounts owing, and his expenses incurred in the hearing.
Result:
Mr. Riviezzi is not entitled to any category of benefits after October 30, 1994.
I need not decide the category of benefits which would be payable to Mr. Riviezzi.
Mr. Riviezzi is not entitled to his expenses.
Hearing:
The hearing was held at the offices of the Ontario Insurance Commission in North York, Ontario, on April 23, 24, and 25, 1996, before me, Frederika Rotter, Senior Arbitrator.
Those present at the hearing and the exhibits entered are listed in Appendices I and II.
Background
Mr. Riviezzi was 41 years old at the time of the accident on the TTC bus, which took place February 28, 1994. He and his wife, together with their daughter, Penelope, arrived in Canada from Uruguay on August 29, 1993. Their son, Pablo, is still living in Uruguay.
Mr. Riviezzi completed eight years of schooling in Uruguay. He then started to work. Prior to coming to Canada, Mr. Riviezzi had worked for 23 years as a salesman in a lumber business in Montevideo, Uruguay. He claims that before his motor vehicle accident, his health was always perfect, and he had never seen any doctors.
Mr. Riviezzi claimed refugee status in Canada and was not authorized to work, pending the determination of his refugee claim. He testified that he and Mrs. Riviezzi started attending English as a Second Language ("ESL") classes, in September 1993, in North York, Ontario, the municipality in which they lived. They attended classes five days a week, approximately five hours daily. Mr. Riviezzi testified that until the accident, he and his wife had never missed a day of classes. They got to their classes by bus. Other than that, Mr. Riviezzi described his activities as helping out at home, and attending at church, social and recreational activities.
Mr. Riviezzi claims he was injured on February 28, 1994, in an incident on a TTC bus, en route to his ESL class. Mr. Riviezzi, his wife, and the bus driver, testified about what occurred on that day. All their evidence indicates that the bus braked suddenly, to avoid a collision. Mr. Riviezzi, and his wife, who were seated at the very back of the bus, were thrown forward. Mrs. Riviezzi fell to the floor, injuring her knee. Mr. Riviezzi avoided a fall by grabbing a vertical pole. He testified he had to support all of his body weight on his right leg, but did not actually strike any part of his body, or his head, against any part of the interior of the bus.
At this point the bus was less than a hundred yards from its terminal destination, the Finch subway station in North York. The bus driver proceeded to the terminal and then spoke with Mr. and Mrs. Riviezzi to see how they were. Mr. Riviezzi was concerned for his wife, who was in some distress (her knee hurt and was bleeding.) Although they at first intended to continue on to their class, they agreed to await an ambulance which took them to the emergency room of the NorthYork General Hospital.
Mr. Riviezzi did not complain to the bus driver of any pain or injury immediately after the incident. At that point, he testified, he was most concerned for his wife, and he himself felt no pain. Similarly, he was not examined at the hospital emergency room, because at that time he was aware of no injury and said he felt no pain or distress.
Mr. Riviezzi subsequently accompanied his wife to see Dr. Mendez, a Spanish speaking physician, for follow up of her complaints. Dr. Mendez' medical notes and records2 show that on March 11, 1994 (11 days after the incident) Mr. Riviezzi complained of headaches, tension, difficulty sleeping and an inability to concentrate, allegedly as a result of the TTC incident. On April 5, 1994, he again complained to Dr. Mendez of headaches and first complained of right knee pain. On April 22, 1994 he first complained of left shoulder pain. Mr. Riviezzi testified at the hearing that his pain actually started the day after the incident, although at the time he did not think he needed to see a doctor about it.
Mr. Riviezzi applied to Markel for accident benefits on March 18, 1994, complaining of neck, back and left shoulder pain, headaches, anxiety, insomnia, loss of concentration and memory, and post traumatic stress. He did not indicate he suffered a knee problem.
Mr. Riviezzi received "other disability benefits"("ODBs") until October 1994. He claims his benefits should not have been terminated because he continues to be disabled as a result of the accident. He also claims he should have received "educational disability benefits" ("EDBs") because he was in full-time attendance at ESL classes at the time of the accident, and suffered a substantial inability to continue his education.
Mr. Riviezzi testified that he has not resumed his ESL classes since the accident.3 He claims he continues to be disabled from pursuing his ESL studies, and from performing his normal daily activities, as a result of his injuries from the accident. He claims he suffers a partial inability to carry on a normal life due to both physical and psychological impairments which he attributes to the TTC incident. He has received various treatments and therapies but feels that none of them have helped him resolve his problems.
Mr. Riviezzi testified he was actively involved with his church activities prior to the accident. He is a committed member of the Mormom Church and regularly attends church services. He testified that before the accident, he used to socialize at the church, participating in sports events and picnics on Wednesday afternoons. He claims he also used to participate in the door to door missionary work of the church.
He testified he also used to participate in other sports activities, and used to go walking with his wife. He also would occasionally help her with household chores such as taking out the garbage.
Findings:
Mr. Riviezzi is entitled to ongoing weekly ODBs under subsection 19(1) of the Schedule if he can show that as a result of his injuries he has sustained an impairment which results in a partial or complete inability to carry on a normal life.
In the alternative, Mr. Riviezzi may be entitled to EDBs under subsection 15(1) of the Schedule if he can show that he was enrolled on a full time basis in elementary, secondary or post-secondary education at the time of the accident and suffers a substantial inability to continue his education, or suffers a partial or complete inability to carry on a normal life.
Mr. Riviezzi has the onus of proving that he is entitled to benefits under the legislation. He maintains that he suffers a partial inability to carry on a normal life because in the accident, he sustained impairments (specifically, the knee injury and psychological sequelae) which have resulted in his substantial inability to engage in mobility activities, household activities, abilities that require the exercise of cognitive powers and abilities to control emotions and behaviour. He claims that because of his knee pain, he cannot resume his former activities.
The evidence before me does not support Mr. Riviezzi's claim that he is disabled from continuing with his ESL classes. Similarly, the evidence does not suggest that he has in any respect suffered an impairment, as a result of the TTC incident, that results in any partial or complete inability to lead a normal life. Accordingly, I am of the view that, in this case, I need not decide which category of benefit would apply.
I first turn to the alleged orthopaedic injuries.
Mr. Riviezzi claims he injured both his left shoulder and his right knee in the TTC incident. I note that Mrs. Riviezzi also physically injured those parts of her body, and received benefits as a result of those injuries. Mr. Riviezzi claims that his shoulder now only bothers him sometimes, and I heard no evidence as to any disabling effects of this shoulder injury. Mr. Riviezzi focussed on his knee pain, which, he testified, is "always there," and prevents him from walking about as usual, playing sports, doing missionary work, helping out at home, or sitting in his ESL class and concentrating on his studies. He claims the pain has also led to memory and cognitive problems and other psychological difficulties.
Mr. Riviezzi's knee problem and pain complaints have been examined, investigated, and treated by a considerable number of medical and psychological practitioners and specialists. All of the professionals who have physically examined him agree that Mr. Riviezzi continues to complain of knee pain, and have generally found that his knee was tender to palpation. However, I do not accept Mr. Riviezzi's contention that his knee pain has prevented him from continuing his education, or has resulted in a partial inability to carry on a normal life. Further, I do not accept his allegation that this knee pain was caused by an injury from the TTC incident.
None of the doctors who examined him found that his knee problem disabled him from attending his ESL classes, or in any other respect. His family doctor, Dr. Hector Mendez, testified at the hearing and candidly agreed that based on the physical findings, Mr. Riviezzi was never at any time prevented from attending English classes.
Dr. Mendez initially directed Mr. Riviezzi to physiotherapy and subsequently sent him to see Dr. Pierre Kirwin, a specialist in physical medicine and rehabilitation.
Dr. Kirwin saw Mr. Riviezzi on at least three occasions in 1994. On August 30, 1994 he reported that Mr. Riviezzi suffered from "multiple soft tissue strains"4 and suggested that physiotherapy be discontinued, and that Mr. Riviezzi enroll in a chronic pain management program. Dr. Kirwin also wrote that he "encouraged him to follow through with his English as a Second Language course as well."
At the request of the TTC, Mr. Riviezzi was seen by Dr. Reuben Lexier, an orthopaedic surgeon, who performed an insurer's medical examination. Dr. Lexier reported on July 21, 1994 that Mr. Riviezzi required no active ongoing treatment. He indicated that Mr. Riviezzi is certainly fit from a medical and orthopaedic point of view to resume his studies as a student at school if he should so desire.....Certainly if he does desire to return to school he could do so immediately from an orthopaedic point of view.
No long term sequelae are anticipated as a result of the injuries sustained in this motor vehicle accident. This minor incident aboard the bus does not limit his physical activities in any fashion at this time, either from a recreational point of view or from a work point of view.
(Emphasis added)
Mr. Riviezzi was also examined, at the request of the TTC, by Dr. Perry S. Tepperman, a physiatrist. Dr. Tepperman reported in September 1994 that Mr. Riviezzi's inability to resume his English classes was not due to his physical condition, and suggested that non-organic factors made a significant contribution to Mr. Riviezzi's persistent symptoms.
Finally, in August 1995 Mr. Riviezzi was also assessed by a team of specialists at the Columbia Comprehensive Rehabilitation Centre ("Columbia"), a Designated Assessment Centre. Dr. H. Weinberg, an orthopaedic surgeon, examined Mr. Riviezzi and wrote that "The knee problem does not appear to be disabling except perhaps for sports activity. I do not see any medical problems that would prevent Mr. Riviezzi from returning to school." Dr. Weinberg felt Mr. Riviezzi should be encouraged to resume normal activity as much as possible.
Similarly, a physiotherapist from Colombia reported that "On physical examination there were no significant limitations that should significantly impact his lifestyle."5
In summary, none of the extensive medical evidence even vaguely suggests that Mr. Riviezzi is physically impaired or prevented, because of his knee problems, from attending ESL classes. Neither does the evidence remotely suggest that he suffers a substantial inability to engage in his everyday mobility or household activities. I find that the possible restriction on his sports activities, which is the only documented physical limitation, does not, in and of itself, amount to a substantial inability to engage in mobility activities. The evidence is that Mr. Riviezzi can walk without difficulty, and continues to take the TTC as needed. As for his household activities, Mrs. Riviezzi stated that Mr. Riviezzi no longer helps her with the garbage, as he used to. I heard no other evidence which would tend to show that Mr. Riviezzi suffers a substantial inability to engage in his former household activities. Accordingly, this aspect of the claim is dismissed.
Furthermore, and in any event, I find that Mr. Riviezzi's knee pain was not caused by the TTC incident. Dr. Lexier testified that when the knee is injured, a person usually notices a popping or snapping noise, and experiences swelling and pain almost immediately. Mr. Riviezzi never reported such signs or symptoms. Moreover, a person experiencing a significant knee injury would not be able to walk comfortably immediately afterwards. Because Mr. Riviezzi experienced no immediate, acute symptoms, Dr. Lexier was of the view that if he had suffered any knee injury at all in the TTC incident, it was a mild strain that would have resolved within four to six weeks. Dr. Lexier testified that in his opinion, Mr. Riviezzi's ongoing knee complaints are idiopathic in origin (i.e. of spontaneous or unknown cause). They could be attributable to a previous work-related or sports-related injury, or simply the result of degenerative changes.
I accept Dr. Lexier's opinion, which I find reasonable and consistent with the evidence. His view is supported by Dr. Mendez, who testified that he too would normally have expected Mr. Riviezzi to have complained of right knee pain on March 11, 1994 when he first saw him. However, on that date Mr. Riviezzi only complained of headaches, and seemed to be primarily focussed on and concerned about the condition of his wife.6
I also note that none of the other medical experts, in their evidence, provided any helpful views or information about the origin of Mr. Riviezzi's knee complaints. They appeared to simply accept Mr. Riviezzi's assertion that he injured his knee in the TTC incident, without questioning the mechanism of the injury.
Mr. Riviezzi gave extremely inconsistent information about when he first noticed his knee problem, and when he sought medical attention for it. At the hearing, he testified that he experienced knee pain the day after the accident. He also told Mr. Fung, the physiotherapist at Columbia, that he felt significant knee pain the day after the accident. He told Dr. Kirwin he noticed right knee pain within 2-3 days. He told Dr. Lambros Mermigis, the psychologist from Columbia, that he experienced pain "immediately,"7 but did not focus on his own symptoms because his wife had fallen. He also told Dr. Tepperman that he experienced discomfort "immediately after the incident," and Dr. Tepperman in his report was under the impression that Mr. Riviezzi was accordingly examined on the same day at the North York General Hospital.8Mr. Riviezzi told Dr. Judith Pilowski, a psychologist who was treating him for his various psychological complaints, that he developed pain in his arm and leg at home, later on the day of the accident, and that he decided to seek medical attention the following day.9
With all of this, Mr. Riviezzi was unable to explain at the hearing why he did not complain of knee pain to Dr. Mendez until April 5, 1994, over one month later. He also could not explain why he "forgot" to mention knee pain in the list of his symptoms, in his application for accident benefits, dated March 18, 1994.10 When questioned, at the hearing, he replied that he did not think it was important. I do not accept this explanation. I conclude that it is more likely that Mr. Riviezzi did not hurt his knee at all in the incident of February 28, 1994. That is consistent with his statements and behaviour at the scene, and in the emergency room, immediately afterwards. It is also consistent with the opinion of Dr. Lexier. I find that when, weeks later, Mr. Riviezzi began to experience knee pain, he attributed it to the accident, to enhance his claim for benefits.
Similarly, I do not accept that Mr. Riviezzi suffered any psychological injury which prevented him from continuing with his English classes, or otherwise resulted in even a partial inability to lead a normal life. I received no persuasive evidence that Mr. Riviezzi suffers a substantial inability to engage in activities requiring the exercise of cognitive powers, or the ability to control his emotions or behaviour.
Mr. Riviezzi did not strike or physically injure his head in the TTC incident. His complaints of psychological trauma, injury and distress resulting from the incident are not credible. I find that the incident was a relatively minor event, which jostled Mr. Riviezzi but caused him no physical harm. I accept that he was distressed as a result of his wife's fall. However, I do not accept that the incident was so traumatic to Mr. Riviezzi as to give rise to the numerous psychological problems and symptoms of which he later complained.
As indicated above, Mr. Riviezzi initially complained to Dr. Mendez of headaches, anxiety, loss of concentration, and difficulty sleeping. He later complained of cognitive difficulties and loss of memory. He complained that he was short-tempered with his daughter. He related these symptoms and behaviours solely to the minor incident on the bus.
Mr. Riviezzi was a refugee claimant who had arrived in Canada from Uruguay just six months prior to the incident on the bus. He testified at the arbitration hearing that he came to Canada to escape persecution in Uruguay. He stated that he had experienced death threats in Uruguay and feared for his life, and for the lives of his immediate family members. (His son is still in Uruguay.) Mr. Riviezzi's immigration status in Canada is uncertain pending the determination of his refugee claim. At the time of the arbitration hearing, a decision on his refugee claim had not yet been made. If the decision were ultimately negative, he and his family might well be required to return to Uruguay. At the time of the TTC incident, neither Mr. Riviezzi nor his wife and daughter were authorized to work, and they were all dependent on welfare assistance.
Given this situation, Mr. Riviezzi might well be experiencing anxiety and distress, at or about the time of the TTC incident. However, he did not disclose any of the details about his immigration status to any of the medical advisors he consulted about his problems. None of the medical or psychological experts, in their reports, refer to Mr. Riviezzi's immigration status, or to the stressful events which led to his coming to Canada.
Dr. Mendez testified at the hearing that he was not aware that Mr. Riviezzi had made a refugee claim. He agreed that this information would have been relevant in making a psychiatric diagnosis.
Dr. Lambros Mermigis, the psychological assessor at Columbia, reported that when Mr. Riviezzi was queried about the reason for his migration to Canada, he stated "that he would rather not answer that question."11
Dr. Lorne Switzman, is a clinical psychologist who examined Mr. Riviezzi, in connection with the Insurer's medical examination. Dr. Tepperman had referred Mr. Riviezzi to Dr. Switzman because he found little physical basis for Mr. Riviezzi's various complaints.
Dr. Switzman testified at the hearing that he asked Mr. Riviezzi about his family history and general situation. Mr. Riviezzi told Dr. Switzman that he had emigrated from Uruguay to Canada because he wished to be closer to his brother and sister who live in Canada. Dr. Switzman testified that the information that Mr. Riviezzi was a refugee claimant, who had allegedly experienced threats and persecution in Uruguay, would have been important and relevant to any psychological evaluation.
I find that Mr. Riviezzi was not honest with the medical and psychological experts who attempted to evaluate his psychological complaints. He deliberately concealed or failed to reveal very significant facts which would have affected their views of his psychological status, and the cause of his difficulties.
In any event, there is little objective professional support for Mr. Riviezzi's complaints of psychological injury or impairment. The only expert who apparently supports Mr. Riviezzi's claim of disability is Dr. Judith Pilowsky, a clinical psychologist who provided psychotherapy to Mr. Riviezzi in 1995. On the basis of an interview with Mr. Riviezzi and psychological test results, she concluded in May 199512 that Mr. Riviezzi's pain prevented him from finding work, and that cognitive changes in Mr. Riviezzi's memory and concentration prevented him from learning English and attending classes.
Dr. Pilowsky did not testify at the hearing, and her evidence is thus untested. It is clear from her report that she knew nothing about Mr. Riviezzi's refugee claim, and attributed all his complaints and symptoms to the motor vehicle accident. In her report, she provides no objective explanation for her opinion that Mr. Riviezzi is prevented from seeking work, attending classes or learning English, and seems to base her view on Mr. Riviezzi's subjective reports and inaccurate history (including his statement that he felt pain the day of the accident and sought medical attention the next day).
Dr. Switzman testified at the hearing that he disagreed with Dr. Pilowsky's opinion. He concluded that Mr. Riviezzi's complaints were likely related to a chronic pain syndrome and that he did not require further psychotherapeutic intervention. Dr. Switzman thought attending classes would be therapeutic for Mr. Riviezzi. He felt Mr. Riviezzi should be strongly encouraged to resume his English classes, and found no evident psychological barrier preventing him from doing so.13 At the hearing, he testified that he felt that from a psychological standpoint, nothing was preventing Mr. Riviezzi from fully resuming his former lifestyle and all of his former activities. I accept this opinion over the untested opinion of Dr. Pilowsky. Dr. Mermigis, an assessor from Columbia, also agreed that Mr. Riviezzi should return to school. He reported that Mr. Riviezzi's psychological difficulties did not justify postponing a return to classes. Dr. Mendez, the family doctor, found that Mr. Riviezzi was "pain focussed" but he also emphasized that "the return to school is essential."
To summarize, even based on the incomplete and inaccurate information provided by Mr. Riviezzi, most of the medical and psychological experts found that he was not prevented or disabled from returning to his ESL classes, or prevented from resuming any other activities that require the exercise of cognitive powers. Similarly, there was no objective evidence to support the claim that Mr. Riviezzi suffered a substantial inability to engage in activities that require the ability to control emotions or behaviour.
Most importantly, none of the experts have had the opportunity to review or assess Mr. Riviezzi's psychological problems on the basis of all the relevant facts, including the facts about his refugee claim and uncertain immigration status. This crucial deficiency casts doubt on any conclusions linking his psychological complaints to this accident. It also seriously affects my view of Mr. Riviezzi's credibility, sincerity, and bona fides in presenting his claim.
I conclude that Mr. Riviezzi was not impaired, as a result of the TTC incident, so as to be prevented or disabled from returning to his ESL classes. Neither has he satisfied me that he has suffered any impairment that results in a partial or complete inability to carry on a normal life. I find that any psychological distress that Mr. Riviezzi may have experienced as a result of the accident (and particularly its effect on his wife) was not in any respect disabling to him, and was likely of short duration.
Expenses
Mr. Riviezzi has asked for his expenses of the arbitration hearing. Arbitrators have a discretion under the Insurance Act to award expenses to an applicant, and such expenses need not follow the result of the hearing. Applicants may be awarded their expenses where they have presented an arguable and bona fide case, even when they are not successful.
In the present case, I decline to exercise my discretion in favour of Mr. Riviezzi, for reasons discussed in the body of this decision. I find that Mr. Riviezzi was neither candid nor credible in presenting his claim. I have outlined, in my findings, some of my concerns about the inconsistencies and omissions in his testimony, and in his presentation and reports to his various health providers.
All of the inconsistencies and deficiencies in his evidence reinforce my view that Mr. Riviezzi is not an honest claimant, and has not presented a bona fide claim. He has been dishonest with his doctors and dishonest in this arbitration hearing. He has attempted to benefit financially from what was, for him, a relatively minor and trivial mishap.
He has caused the Insurer and our health care system to incur extensive and unwarranted expenses. The documentation and evidence before me indicates that Mr. Riviezzi had physiotherapy, massage therapy, psychotherapy and various other treatments, all paid for by the Insurer. The Insurer also engaged a small army of medical and psychological experts to investigate and assess Mr. Riviezzi's various complaints.
Under the circumstances, I do not feel it appropriate to award Mr. Riviezzi his expenses of this arbitration proceeding.
Order:
Mr. Riviezzi is not entitled to further weekly accident benefits.
Mr. Riviezzi is not entitled to his expenses incurred in respect of the arbitration proceeding.
August 20, 1997
Frederika Rotter Senior Arbitrator
Date
Appendix I
Present at the Hearing:
Applicant: Ramon Riviezzi
Mr. Riviezzi's Representative: Frank Loreto Barrister and Solicitor
Markel's Representative: Boyd Critoph Barrister and Solicitor
Markel's Claims Manager: Spanish-English Interpreter: Gary Hutcheon Luis Alvarado
Witnesses:
Mr. Ramon Riviezzi Mr. Gurpreet S. Roddey Dr. Hector Mendez Mrs. Aracely Sena Riviezzi Dr. Lorne A. Switzman Dr. Reuven R. Lexier
Appendix II
Exhibits:
Exhibit 1 Application for Accident Benefits dated March 18, 1994
Exhibit 2 Statement by Ramon Riviezzi dated February 28, 1994
Exhibit 3 Medical Reports of Ramon Riviezzi
Exhibit 4 Curriculum Vitae of Dr. Lorne A. Switzman
Exhibit 5 Medical Report of Dr. Judith Pilowsky dated January 22, 1996
Exhibit 6 3 surveillance videotapes of Mr. and Mrs. Riviezzi taken May 20, June 7, August 17/18, 1994
Exhibit 7 Mr. Riviezzi's attendance record at ESL classes at Latin American Communication Centre
Exhibit 8 Motor Vehicle Accident Report dated February 28, 1994
Exhibit 9 Curriculum Vitae of Dr. Reuven R. Lexier
Footnotes
- The Statutory Accident Benefits Schedule —Accidents on or after January 1, 1994, called "the Schedule" in this decision. The Schedule is Ontario Regulation 776/93, as amended by Ontario Regulation 635/94.
- Exhibit 3, Tab 2
- Exhibit 7, a letter from the Latin American Community Centre dated April 23, 1996, states their attendance records show that Mr. Riviezzi attended ESL classes from January 7, 1994 to March 31, 1994.
- Exhibit 3, Tab 3, report dated August 30, 1994.
- Exhibit 3, Tab 4, Report by Enoch Fung, PT, MCSP, MCPA, Registered Physiotherapist, dated August 24, 1995.
- Exhibit 3, Tab 2, Dr. Mendez' notes and records
- Exhibit 3, Tab 4, Dr. Lambros Mermigis' report dated August 24, 1994
- Exhibit 3, Tab 5, Dr. Tepperman's report dated September 23, 1994
- Exhibit 3, Tab 1, Report of Judith Pilowski, C. Psych, dated May 15, 1995
- Exhibit 2, In Mr. Riviezzi's statement taken on April 4, 1994 he said he did not mention the knee injury in his application "because I did not think of it."
- Exhibit 3, Tab 4, supra
- Exhibit 3, Tab 1, Report of Dr. Judith Pilowski dated May 15, 1995
- Exhibit 3, Tab 5, Report of Dr. Lorne Switzman dated November 1, 1994

