Applicant awarded pre-104 week IRBs but denied post-104 week IRBs and special award.
The applicant sought income replacement benefits (IRBs) and a special award under Regulation 664 following a motor vehicle accident.
The respondent insurer denied the benefits, arguing the applicant's impairments were based on subjective complaints and her evidence was unreliable.
The Tribunal found the applicant credible and determined she suffered a substantial inability to perform the essential tasks of her pre-accident employment as a gas bar attendant, entitling her to pre-104 week IRBs.
However, the Tribunal dismissed her claim for post-104 week IRBs, finding she failed to prove a complete inability to engage in suitable employment, as she had successfully worked part-time jobs post-accident and failed to prove her subsequent surgeries were accident-related.
The claim for a Regulation 664 award was also dismissed, as the insurer's delay in obtaining addendum reports was not unreasonable given the applicant's delay in providing requested documents.
OLATOntario Licence Appeal TribunalAug 11, 2022