Applicant awarded weekly income benefits due to accident-induced depression preventing participation in physical rehabilitation.
The applicant was injured in a rear-end motor vehicle accident and subsequently developed chronic pain syndrome and reactive depression.
The insurer terminated her weekly income benefits after she failed to complete a functional restoration program, arguing she was physically capable of working and her failure to cooperate was wilful.
The arbitrator found that the applicant's failure to participate in therapy was not wilful but rather a symptom of her accident-induced depression and pain.
Consequently, the applicant was entitled to weekly income benefits under section 12(1) of the Schedule until the 156-week mark, and under section 12(5)(b) until September 30, 1995, by which time she had sufficiently recovered psychologically to participate in rehabilitation.
The claim for a special award was dismissed as the insurer's reliance on medical opinions to terminate benefits was not unreasonable.
OFSCDRSOntario Financial Services Commission - Dispute Resolution ServicesSep 28, 1995
