Dr. Eric Rumack

The grievor, a Client Representative, went off work following a car accident and claimed long-term income protection (LTIP) benefits for the 'own occupation' period.

The insurance carrier denied the claim on the basis that she was not totally disabled, citing a lack of objective evidence of cognitive impairment.

The arbitrator found that the grievor's job required significant cognitive demands and that her diminished cognitive efficiency, as confirmed by an independent medical examination, prevented her from performing her essential duties efficiently and accurately.

The arbitrator held that the absence of objective evidence was not a valid reason to deny the claim, given the credible self-reporting of symptoms.

The grievance was allowed, and the grievor was found to be totally disabled during the relevant period.