Dr. K. Isles

The applicant sought statutory accident benefits for chiropractic treatment plans and in-home assessments following a 2012 motor vehicle accident.

The insurer denied the claims based on its medical assessments indicating the injuries were minor and required no further treatment.

The arbitrator dismissed the application in its entirety, finding the applicant completely lacking in credibility due to numerous inconsistencies, evasions, and denials regarding his significant pre-accident medical history.

The arbitrator concluded that the applicant's lack of credibility fundamentally undermined the reliability of his treating practitioners' recommendations, and the applicant failed to establish that the claimed benefits were reasonable and necessary.

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

The central issue was whether the applicant suffered a substantial inability to perform the essential tasks of her pre-accident employment as an assembly line worker.

The arbitrator found the applicant credible and accepted the evidence of her treating family doctor over the insurer's medical examiners.

The arbitrator concluded that the physical demands of the applicant's job, which required continuous standing and repetitive lifting, combined with her accident-related soft tissue injuries and chronic pain, rendered her substantially unable to perform her essential duties.

The applicant was awarded IRBs for the disputed period, along with interest.