David Antflick

The applicant was injured in a motor vehicle accident and sought post-104 weeks income replacement benefits (IRBs), arguing she suffered a complete inability to engage in suitable employment.

The Tribunal preferred the respondent's expert evidence, finding the applicant retained the functional capacity for sedentary work and did not meet the complete inability test.

The Tribunal also held that the respondent correctly deducted the applicant's maternity leave Employment Insurance benefits from her pre-104 weeks IRBs, as they constitute gross employment income under the Schedule.

Finally, the Tribunal dismissed the claim for a special award, finding the respondent's handling of the claim and temporary stoppages of benefits pending further medical information were not unreasonable.

Following the settlement of a motor vehicle accident tort claim, the plaintiffs brought a motion for costs and an increase in the pre-judgment interest rate.

The court assessed the costs of the civil action, reducing the amount claimed to account for expenses incurred due to a trial adjournment requested by the plaintiffs.

The court also considered whether the tort defendant should contribute to the costs the plaintiffs incurred in parallel statutory accident benefits (SABs) proceedings, ultimately ordering a $20,000 contribution because the SABs settlements significantly reduced the defendant's tort exposure.

The plaintiffs' request to increase the pre-judgment interest rate to offset statutory deductible increases was dismissed.

Following a jury trial for a motor vehicle accident claim, the defendant brought a threshold motion arguing the plaintiff's injuries did not meet the statutory requirement of a permanent, serious impairment of an important physical, mental or psychological function.

The plaintiff adduced evidence from multiple medical experts and lay witnesses demonstrating chronic pain that substantially interfered with her employment and daily living.

Despite some credibility issues regarding the plaintiff's employment history and surveillance footage, the court found the corroborating medical and lay evidence sufficient to establish the impairment.

The motion was dismissed.

The appellant employer appealed a trial judgment awarding the respondent former employee damages for lost long-term disability (LTD) benefits and punitive damages following a wrongful dismissal.

The respondent had been diagnosed with cancer after finding alternate employment and claimed he would have been entitled to LTD benefits under the appellant's plan.

The Court of Appeal upheld the LTD benefits award, finding sufficient medical and vocational evidence that the respondent was totally disabled and incapable of working, thus negating any failure to mitigate.

However, the Court set aside the $15,000 punitive damages award because it had not been pleaded or sought at trial.

The applicant was catastrophically injured in a motor vehicle accident shortly after graduating high school.

At the time of the accident, she was working part-time serving meals at a senior's residence.

The insurer paid an income replacement benefit, but the applicant claimed entitlement to the higher non-earner benefit under s. 12(1)(3)(ii) of the Schedule, arguing she had completed her education less than a year prior and her employment did not reflect her education and training.

The arbitrator found that the applicant had 'completed her education' upon receiving her high school diploma, despite speculative plans to attend college.

The arbitrator also found that her menial, part-time job did not reflect her high school education and training.

The applicant was awarded the non-earner benefit with interest.

The claim for a special award was dismissed as the insurer's initial denial was not unreasonable given the ambiguity in the law.

The applicant was injured in a motor vehicle accident and received income replacement benefits.

The insurer terminated these benefits at the 104-week mark based on a multidisciplinary assessment suggesting the applicant could perform alternative employment.

The applicant sought a special award, arguing the termination was unreasonable.

The arbitrator found that the insurer failed to critically assess the expert reports, which contained significant inconsistencies and ignored the applicant's pre-accident income and limited education.

The insurer's reliance on a flawed assessment process and failure to consider credible evidence to the contrary constituted an unreasonable withholding of benefits.

A special award of 40% of the withheld benefits was ordered.

The insurer brought a motion to compel the insured to attend an in-person vocational assessment examination and to stay the arbitration hearing until she complied.

The insurer had previously obtained a paper review report from its vocational expert, who stated his conclusions were reliable and comprehensive.

The arbitrator found that the insurer's request, made more than four years after benefits were terminated and shortly before the hearing, was for hearing preparation rather than ongoing claims assessment.

The arbitrator concluded the examination was not reasonably necessary under section 42 of the Statutory Accident Benefits Schedule and allowed the arbitration to proceed.

The applicant was injured in a motor vehicle accident and received income replacement benefits until the insurer terminated them after 104 weeks.

The applicant sought arbitration, claiming a complete inability to engage in any employment for which she was reasonably suited.

The arbitrator reviewed the applicant's education, training, and work history, noting she primarily worked part-time.

Relying on the consensus of the applicant's own medical experts that she could return to part-time sedentary work, the arbitrator found she did not meet the test for complete inability to work.

The application for income replacement benefits and a special award was dismissed.

The applicant was injured in a motor vehicle accident and sought ongoing income replacement benefits beyond the 104-week mark, as well as the cost of a golf cart as a rehabilitation expense.

The insurer terminated benefits, arguing the applicant's inability to work was due to a pre-existing back injury and that she was capable of working with accommodations.

The insurer also argued that the applicant's HOOPP disability pension should be deducted from any income replacement benefits.

The arbitrator found that the motor vehicle accident materially contributed to the applicant's impairments, rendering her completely unable to perform any suitable occupation.

The arbitrator also held that the HOOPP pension was not an income continuation plan or temporary disability benefit, and thus was not deductible.

The applicant was awarded ongoing income replacement benefits and the cost of the golf cart.

The applicant, a military reservist, was struck by a motor vehicle and received weekly income benefits for 198 weeks.

The insurer terminated benefits, arguing the applicant could return to light sedentary work.

The arbitrator found that while the applicant was physically capable of light sedentary work, he was not 'reasonably suited' for such employment by his education, training, or experience, given his long career in a demanding military role.

The arbitrator also determined the correct quantum of the weekly benefit based on bank records, as official payroll records were unreliable.

The insurer's claim for repayment of prior overpaid benefits was dismissed because the applicant did not contribute to the error.