The claimant sought a determination that he suffered a catastrophic impairment under the Extended Glasgow Outcome Scale (GOS-E). The parties agreed that the claimant sustained a mild traumatic brain injury and a fractured pelvis as a result of the accident, and agreed that the brain injury was evidenced on medical imaging. To receive a catastrophic impairment designation, the claimant had to prove either: (1) an Upper Severe Disability or Lower Severe Disability six months or more after the accident; or (2) a Lower Moderate Disability one year or more after the accident. The parties disagreed on the appropriate timing of the GOS-E assessment, and whether non-brain injury disabilities were to be included in the GOS-E assessment. Adjudicator Neilson accepted the insurer’s arguments that the GOS-E could be completed at any time after six months or one year (respectively), and did not need to be taken precisely at the six month or one year anniversary. Adjudicator Neilson also accepted the insurer’s argument that the GOS-E assessment required the completing physician to parse out the physical and psychological injuries and impairments not caused by the brain injury in order to properly complete the GOS-E rating. Adjudicator Neilson also found that the claimant’s experts did not completed the GOS-E assessment properly in that: (1) parts of the assessment were completed by an occupational therapist rather than a physician; and (2) the questionnaire that was administered was an abbreviated version rather than the full version. Adjudicator Neilson concluded that the claimant did not suffer a catastrophic impairment under the GOS-E criteria.
