Denys Remedios

The applicant sought statutory accident benefits following a motor vehicle accident, including pre- and post-104 week income replacement benefits, chiropractic treatment plans, and the cost of a disability certificate.

The adjudicator found the applicant to be an unreliable witness due to inconsistencies in her testimony and self-reporting.

The adjudicator concluded the applicant did not suffer a substantial or complete inability to perform her employment tasks, noting her physical injuries were minor exacerbations of pre-existing conditions and there was no objective evidence of psychological impairment.

The claims for income replacement benefits, treatment plans, and the disability certificate were dismissed.

The respondent's request for costs of a motion was also dismissed.

The applicant was injured in a serious motor vehicle accident and received income replacement benefits (IRBs).

The insurer terminated IRBs after the applicant attempted a return to work but had to stop due to severe headaches and vomiting.

The insurer later reinstated benefits and paid arrears on the eve of the arbitration hearing.

The arbitrator found that the insurer unreasonably withheld benefits by ignoring the overwhelming medical evidence from treating practitioners and selectively reading its own experts' reports.

The arbitrator awarded a special award of $25,000, inclusive of compound interest, under s. 282(10) of the Insurance Act.

Liberty Mutual appealed an arbitration order awarding the respondent loss of earning capacity benefits (LECBs).

The insurer argued the arbitrator erred in calculating both the pre-accident earning capacity (PEC) and residual earning capacity (REC), specifically by accepting a PEC higher than the respondent's reported tax income and finding a REC of zero.

The Director's Delegate dismissed the appeal, holding that the arbitrator took an appropriately flexible approach to determining PEC for a self-employed individual and made no error of law in rejecting the insurer's proposed residual employment options.

The applicant, a self-employed aluminum installer, suffered a shoulder separation in a motor vehicle accident.

The insurer paid income replacement benefits for 104 weeks and then assessed his loss of earning capacity at zero.

At arbitration, the arbitrator determined the applicant's pre-accident earning capacity by estimating his cash income, which was not reported on his tax returns.

The arbitrator found the applicant's residual earning capacity to be nil, rejecting the insurer's proposed alternative occupations because they did not suit the applicant's personal and vocational characteristics, including his age, limited English skills, and preference for independent, non-routine work.

The applicant was awarded a weekly loss of earning capacity benefit of $251.45.