Diamantis Zervas

The applicant was involved in a motor vehicle accident and sought post-104 income replacement benefits (IRBs) due to psychological impairments.

The respondent terminated IRBs based on insurer examinations suggesting the applicant could work in alternative roles or teach yoga.

The Tribunal found that the applicant suffered from severe depression and anxiety that prevented her from maintaining regular attendance or performing duties in a competitive, real-world setting comparable to her pre-accident career as a mental health consultant.

The Tribunal ordered the respondent to pay the post-104 IRBs with interest, but dismissed the applicant's claim for a special award under s. 10 of O. Reg. 664, finding insufficient evidence of unreasonable conduct by the insurer.

The applicant was injured in a motor vehicle accident in 2016, sustaining a severe right elbow fracture.

He received income replacement benefits (IRBs) for the first 104 weeks, after which the respondent denied further IRBs.

The applicant applied to the Licence Appeal Tribunal, claiming a complete inability to engage in any suitable employment due to physical pain, fear of reinjury, and psychological impairments including depression and anxiety.

The adjudicator dismissed the application, finding that the applicant's physical injuries had healed and his psychological issues were primarily related to boredom and lack of motivation rather than a complete inability to work.

The adjudicator preferred the respondent's expert evidence, which demonstrated the applicant retained the functional capacity and vocational aptitude for alternative employment.