Dr. Koppert

The applicant was injured in a rear-end motor vehicle accident and claimed ongoing statutory accident benefits after the insurer terminated them.

The arbitrator found that the applicant suffered a substantial inability to perform the essential tasks of her pre-accident employment as a waitress for the first 156 weeks, rejecting the insurer's medical assessments that she could work part-time.

However, the applicant failed to prove she was continuously prevented from engaging in any suitable employment after the 156-week mark, as she was capable of attending school full-time and could perform suitable minimum-wage jobs.

The arbitrator also awarded supplementary rehabilitation benefits for school transportation and alternative therapy.

The appellant was injured in a motor vehicle accident and received weekly income benefits for three years until the insurer terminated them.

An arbitrator upheld the termination, finding the appellant could work in a clerical setting.

On appeal, the Director's Delegate found the arbitrator failed to address key medical evidence from the insurer's own orthopaedic specialist, who considered the appellant completely unfit to work.

The arbitrator also failed to explicitly rule on the period between the termination date and the hearing, and did not sufficiently analyze the appellant's pre-accident employment.

The appeal was allowed, the arbitration order rescinded, and the matter remitted for a new hearing.