2 total
Income benefits denied where surveillance evidence contradicted applicant's claims of disabling chronic pain.
The applicant, a taxi driver, was injured when pinned between two vehicles.
He claimed ongoing weekly income benefits, alleging chronic pain and depression prevented him from working.
The insurer terminated benefits after medical assessments indicated he could return to work.
The arbitrator dismissed the claim for ongoing benefits, finding the applicant lacked credibility, exaggerated his symptoms, and had been working covertly at his brother's store, as revealed by surveillance evidence.
The medical opinions supporting disability were rejected as they relied on the applicant's unreliable subjective reporting.
The applicant was awarded one-third of his expenses.
Claim for ongoing income benefits dismissed; limited housekeeping expenses awarded based on psychological expert evidence.
The applicant was injured in a motor vehicle accident and received statutory accident benefits until the insurer terminated weekly income benefits.
The applicant sought arbitration for ongoing weekly income benefits and housekeeping expenses, claiming disability due to chronic pain and fibromyalgia.
The arbitrator preferred the evidence of the insurer's psychological expert, finding that the applicant's pain behavior was not organically based and was inadvertently reinforced by her family.
The arbitrator concluded the applicant was not disabled from working and dismissed the claim for ongoing income benefits.
However, the arbitrator awarded $4,780 for housekeeping and babysitting expenses incurred during a reasonable recovery and transition period.
No co-appearing lawyers found.
No judges found.