An Ontario tribunal dismissed a bid for catastrophic impairment status after surveillance and social media posts undercut the claimant's reported limitations.
The Licence Appeal Tribunal released its decision on June 24, 2026. The claimant was injured in an accident on November 4, 2013, and sought statutory accident benefits under the Schedule. The insurer, Royal & Sun Alliance Insurance Company of Canada (RSA), denied the benefits, and the dispute proceeded to a hearing over whether she was catastrophically impaired.
Under the applicable Schedule, a person is catastrophically impaired if an accident causes a marked or extreme impairment in one of four areas of function due to a mental or behavioural disorder, assessed against the American Medical Association's Guides to the Evaluation of Permanent Impairment, 4th edition. The four areas are activities of daily living, social functioning, concentration, persistence and pace, and adaptation.
Both parties' assessors agreed the claimant sustained psychological injuries from the accident, but disagreed on severity. Her psychiatrist rated her as Class 4, marked, in three areas. The insurer's psychiatrist rated her activities of daily living as Class 3, moderate. Neither found a marked or extreme impairment in social functioning, and the parties agreed she could not qualify on that basis.
Surveillance and social media evidence proved decisive. The claimant had told her psychiatrist that she did nothing after the accident. The adjudicator found that account hard to reconcile with posts showing rock concerts, a gun range, a casino, a Raptors game, and numerous vacations, including four trips to Cuba and trips to Mexico, Florida, Ireland, and a honeymoon in the Dominican Republic. The volume of posts, he wrote, was "more consistent with an ability to participate in social and leisure activities."
The claimant's psychiatrist had not reviewed the social media posts. Surveillance video also showed her driving to a medical appointment, grocery shopping, and completing errands in a timely fashion.
The tribunal also weighed post-accident work. The claimant continued to perform as a singer in a country rock band, singing three to five sets over a five-hour period, and ran a home business making cooking videos for a company selling spices and kitchen items. The adjudicator treated both as examples of useful functioning, noting the singing occurred in front of an audience despite accommodations such as printed lyrics.
Ultimately, the adjudicator rated the claimant as having a Class 3, moderate impairment in activities of daily living, in concentration, persistence and pace, and in adaptation. Because none reached the marked or extreme threshold, she was found not to be catastrophically impaired, and the application was dismissed.
For insurers and claims professionals, the decision underscores the weight a tribunal can place on surveillance and social media when they conflict with an assessment, and the value of ensuring assessors review the full evidentiary record before rating impairment.
