4 total
Insurer ordered to pay ongoing caregiver benefits as applicant suffered substantial inability to perform caregiving activities.
The applicant was injured in a motor vehicle accident and received statutory accident benefits.
The insurer terminated her weekly caregiver benefits after 104 weeks, asserting she did not suffer a complete inability to carry on a normal life.
The applicant argued she suffered a substantial inability to engage in her pre-accident caregiving activities for her adult son, who had a severe brain injury.
The arbitrator found that the applicant's physical limitations, including osteoarthritis and restricted mobility, prevented her from meaningfully engaging in her pre-accident caregiving activities.
The arbitrator ordered the insurer to pay ongoing weekly caregiver benefits and interest, but denied the claim for a special award.
Claim for experimental bovine extract treatment denied as not reasonable or necessary under the Schedule.
The applicant was injured in a motor vehicle accident and sought payment for a naturopathic treatment known as bovine extract under section 6 of the Statutory Accident Benefits Schedule.
The insurer denied the claim.
The arbitrator dismissed the claim, finding no reliable evidence that the experimental bovine therapy was reasonable or likely to benefit the applicant.
The arbitrator noted the lack of scientific support for the treatment and the applicant's failure to pursue active rehabilitation measures recommended by other assessors.
Claim for ongoing weekly income benefits dismissed as applicant failed to prove continuous disability.
The applicant was injured in a rear-end motor vehicle accident and received weekly income benefits for three years.
He applied for ongoing benefits, claiming physical and psychological disability prevented him from working.
The arbitrator found that while the applicant suffered a herniated disc from the accident, he exaggerated his symptoms and his psychological condition was caused by pre-existing and psycho-social factors unrelated to the accident.
The arbitrator concluded the applicant retained the capacity and skills for suitable employment, such as a retail clerk or in construction trades, and dismissed the claim for ongoing benefits.
Self-employed applicant awarded minimum weekly income benefits due to unreliable records; ordered to repay overpayment.
The applicant was injured in a motor vehicle accident and claimed weekly income benefits from the insurer.
The arbitrator found that the applicant was substantially unable to perform the essential tasks of his self-employment in the video game business from the date of the accident until April 16, 1992.
However, because the applicant operated a cash business and failed to provide credible evidence of his pre-accident or post-accident income, his benefits were calculated at the statutory minimum of $185.60 per week.
As the insurer had already paid benefits exceeding the applicant's total entitlement, the applicant was ordered to repay the overpayment of $6,075.64.
The applicant was awarded the expenses of the arbitration.
No co-appearing lawyers found.
No judges found.