6 total
Hospital liable for plaintiff's fibromyalgia following fall; future care costs reduced due to unproven home maintenance claims.
The plaintiff suffered a cracked sacrum after a bed collapsed at the defendant hospital.
She later developed fibromyalgia, which the trial judge found was caused by the hospital fall despite an intervening car accident.
The trial judge awarded over $3 million in damages, including approximately $1.7 million for future care costs based on expert reports.
On appeal, the defendants challenged the liability finding and the future care costs.
The Court of Appeal upheld the liability finding, noting the trial judge properly applied foreseeability and the thin-skull rule.
However, the Court allowed the appeal in part regarding damages, reducing the future care costs award by $374,640.65 because several home maintenance items lacked evidentiary support.
Application for ongoing income replacement benefits dismissed as applicant failed to prove accident caused her impairment.
The applicant was injured in a motor vehicle accident in December 2005 and received income replacement benefits (IRBs) until August 2008.
She sought IRBs beyond the 104-week mark, requiring her to prove a complete inability to engage in any employment for which she was reasonably suited, caused by the accident.
The applicant advanced several theories of causation, including spinal injuries, exacerbation of pre-existing fibromyalgia, and a psychological disorder.
The arbitrator rejected all theories, finding that the applicant likely only sustained minor soft tissue injuries in the accident, that the cause of fibromyalgia is unknown making exacerbation unprovable, and that the psychological diagnoses lacked adequate foundation.
The application for ongoing IRBs and a special award was dismissed.
Appeals dismissed; arbitrator was not functus after interim order and correctly denied repayment of pre-termination benefits.
The applicant was injured in a motor vehicle accident and received income replacement benefits until the insurer terminated them.
An arbitrator initially found the termination improper under section 37 of the SABS and ordered interim benefits paid until proper notice was given.
After the insurer complied, the arbitrator found the applicant did not meet the substantive test for disability and dismissed her claim for ongoing benefits, but also ruled she was not required to repay the interim benefits paid prior to the proper termination notice.
Both parties appealed.
The Director's Delegate dismissed both appeals, finding the arbitrator was not functus officio after the interim order, did not err in rejecting the applicant's medical evidence, and correctly concluded that requiring repayment of benefits paid before a proper termination notice would render the stoppage provisions meaningless.
Application for income replacement benefits dismissed; applicant failed to prove substantial inability to perform employment tasks.
The applicant was injured in a rear-end motor vehicle collision and claimed income replacement benefits for fibromyalgia and psychological impairments.
The insurer terminated benefits after June 24, 2003.
The arbitrator found that the applicant's physical complaints were not objectively verifiable and preferred the insurer's psychological assessment, which concluded she was not substantially disabled from performing the essential tasks of her employment as a computer sales representative.
The application for arbitration was dismissed.
Applicant awarded 50% of arbitration expenses due to partial success and insurer's delay tactics.
The applicant sought expenses following an arbitration decision where he achieved partial success in his claims for statutory accident benefits.
The insurer also claimed its expenses, relying on two written offers to settle that exceeded the applicant's recovery.
The arbitrator awarded the applicant 50% of his allowable arbitration expenses, considering his partial success, the insurer's conduct in delaying pre-hearing discussions, and the statutory objective of speedy dispute resolution.
The insurer's claim for expenses was denied, as the arbitrator declined to follow a strict results-based approach based solely on the offers to settle.
The applicant's total allowable expenses were assessed at $13,010, resulting in an award of $6,505.
Income replacement benefits awarded for a limited period; ongoing benefits denied based on surveillance and DAC assessment.
The applicant was injured in a motor vehicle accident and sought income replacement benefits and medical benefits after the insurer terminated them.
The arbitrator found that the applicant was entitled to income replacement benefits for a limited period from July 22, 2000, to October 4, 2000, based on his family doctor's evidence of ongoing improvement.
However, relying on surveillance evidence and a Med Rehab DAC assessment, the arbitrator concluded the applicant was substantially able to perform his pre-accident employment as a welder after October 4, 2000.
The arbitrator also awarded $1,522 for chiropractic treatments but denied the claim for physiotherapy and massage treatments, finding them not reasonable and necessary.