The claimant sought a determination that she sustained a catastrophic impairment as a result of the accident. Vice Chair Moore held that the claimant did not suffer a catastrophic impairment under Criterion 7 or Criterion 8. Vice Chair Moore found the insurer’s WPI ratings more persuasive. In particular, the Vice Chair preferred the position of the insurer’s assessors that there needed to be a specific accident-related diagnosis to justify an impairment rating, rather than simply reports of symptoms. Vice Chair Moore was critical of the claimant’s assessors, who appeared to apply WPI ratings in excess of diagnosed accident-related injuries and which were not in accordance with the AMA Guides. Vice Chair Moore found a total of 6 percent WPI for physical impairment, which was too low to combine with psychological impairment to exceed 55 percent WPI. In terms of Criterion 8, Vice Chair Moore found that at least two domains (activities of daily living and concentration, persistence, and pace) did not meet a Class 4 Marked Impairment, and as such, the claimant could not qualify for a catastrophic impairment under Criterion 8. As a procedural preliminary issue, Vice Chair Moore excluded the insurer’s supplementary document brief containing surveillance because it was served on the first day of the hearing. Although the surveillance had been provided during settlement discussions, the Tribunal found that failure to include the surveillance in the original document brief meant that the claimant was not expecting to comment and rebut the findings therein.
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