Dr. John Zeldin

The applicant was injured in a motor vehicle accident and sought ongoing income replacement benefits (IRBs) after the insurer terminated them.

The insurer argued the applicant was unemployed at the time of the accident and exaggerated his symptoms.

The arbitrator found the applicant was employed through a temporary placement agency at the time of the accident and that his pre-accident health issues did not prevent him from working.

Relying on objective medical evidence of a torn shoulder tendon, the arbitrator rejected the insurer's expert opinions that the applicant was magnifying his symptoms.

The arbitrator concluded the applicant was substantially unable to perform the essential tasks of his employment and awarded IRBs up to the date he reported limitations from unrelated health conditions.

The insurer appealed an arbitration order requiring it to pay income replacement benefits, medical benefits, and a $15,000 special award to the claimant following a motor vehicle accident.

The insurer argued the arbitrator erred in accepting the claimant's pre-accident employment contract and finding him disabled from that prospective job.

The Director's Delegate dismissed the appeal regarding the benefits, finding the arbitrator's conclusions were supported by the evidence and no error of law occurred.

However, the appeal was allowed in part regarding the special award.

The Director's Delegate found the arbitrator erred in her analysis by penalizing the insurer for relying on a Designated Assessment Centre report and for an adjuster's poor performance as a witness.

The special award was reduced by 50 percent to $7,500.

The applicant was injured in a motor vehicle accident and applied for statutory accident benefits, including income replacement and medical benefits.

The insurer denied the claims, arguing the applicant did not have a legitimate contract of employment and was not substantially disabled.

The arbitrator found that the applicant had a valid employment contract as a van driver/delivery person and that his accident-related injuries substantially disabled him from performing the heavy lifting and repetitive movements required for the job.

The arbitrator awarded income replacement benefits, medical benefits, and the cost of a disability certificate.

Furthermore, the arbitrator ordered the insurer to pay a $15,000 special award, finding that the insurer had unreasonably delayed and withheld benefit payments by failing to properly investigate the employment contract and by ignoring procedural notice requirements.

The applicant was injured in a motor vehicle accident and sought income replacement benefits and medical benefits after the insurer terminated them.

The arbitrator found that the applicant was entitled to income replacement benefits for a limited period from July 22, 2000, to October 4, 2000, based on his family doctor's evidence of ongoing improvement.

However, relying on surveillance evidence and a Med Rehab DAC assessment, the arbitrator concluded the applicant was substantially able to perform his pre-accident employment as a welder after October 4, 2000.

The arbitrator also awarded $1,522 for chiropractic treatments but denied the claim for physiotherapy and massage treatments, finding them not reasonable and necessary.

The applicant was injured in a motorcycle accident and applied for arbitration regarding his income replacement benefits and loss of earning capacity.

The insurer moved to stay the arbitration pending a report from a designated assessment centre (DAC) regarding residual earning capacity.

The applicant opposed the stay and moved for interim benefits, interim expenses, and housekeeping expenses.

The arbitrator declined to stay the arbitration but adjourned the loss of earning capacity issues pending a proper DAC report.

The arbitrator severed the housekeeping claim and awarded the applicant $500 in outstanding housekeeping expenses and $50 per week ongoing.

The arbitrator also ordered the insurer to pay interim income replacement benefits at $292.07 per week and interim disbursements of $1,738.

The applicant was injured while a passenger on a bus and received statutory accident benefits.

The insurer terminated weekly income benefits and supplementary medical benefits in 1995.

The applicant sought reinstatement of weekly income benefits, and the insurer sought repayment of medical benefits paid for psychological treatment.

The arbitrator found that the applicant was physically and psychologically capable of returning to work by April 1995, dismissing the claim for ongoing weekly income benefits.

The arbitrator also dismissed the insurer's claim for repayment, finding the psychological treatment received prior to termination was reasonable and beneficial.

The applicant was injured in a motor vehicle accident and received weekly income replacement benefits until the insurer terminated them.

The applicant sought arbitration for ongoing income replacement benefits, supplementary medical benefits for physiotherapy, and a determination on the availability of collateral long-term disability benefits.

The arbitrator found that the applicant was substantially unable to perform the essential tasks of her employment due to chronic pain and depression caused by the accident.

The arbitrator awarded ongoing income replacement benefits, partially granted the claim for physiotherapy expenses, and found that long-term disability benefits were not available to reduce the weekly benefits.

The applicant was injured while standing on a bus that stopped suddenly.

She received weekly income benefits until September 13, 1992, and sought further benefits up to February 28, 1993, along with a special award and expenses.

The arbitrator dismissed the claims, finding the applicant lacked credibility due to significant inconsistencies in her accounts of the accident and her failure to disclose prior injuries to assessing doctors.

The medical reports supporting her claim were deemed unhelpful as they relied on her inaccurate history.

The insurer's termination of benefits was found to be reasonable, and expenses were denied due to the applicant's lack of candour.

The applicant was injured in a motor vehicle accident and received weekly statutory accident benefits until the insurer terminated them.

The applicant sought ongoing benefits, claiming a substantial inability to perform his essential tasks.

The arbitrator found that the applicant exaggerated his injuries and that surveillance evidence contradicted his claims of disability.

Relying on the insurer's orthopaedic expert, the arbitrator concluded the applicant's physical injuries resolved shortly after the accident and awarded benefits only for an additional brief period up to October 3, 1990.

The applicant was injured in a motor vehicle accident and claimed ongoing weekly benefits, supplementary medical and rehabilitation expenses, and a special award under the Insurance Act.

The arbitrator found that while the applicant experienced pain and her ability to perform her essential tasks as a home-maker and mother was limited, she did not suffer a 'substantial inability' to perform those tasks as required by the No-Fault Benefits Schedule.

The claim for ongoing weekly benefits was dismissed.

The insurer agreed to pay most of the supplementary medical and rehabilitation expenses, and the arbitrator remained seized of one disputed invoice.

The claim for a special award was dismissed as the insurer did not unreasonably withhold benefits.

The applicant was awarded her expenses for the arbitration.