Dr. Margulies

The applicant was injured in two motor vehicle accidents in 1993 and received statutory accident benefits until the insurer terminated them in January 1997.

The applicant sought ongoing weekly non-earner benefits, arguing that chronic pain and psychological factors continuously prevented her from engaging in substantially all of her pre-accident activities.

The arbitrator reviewed medical evidence from various experts, noting that while the applicant suffered from chronic pain and depression, her physical injuries had healed and she maintained normal muscle bulk, indicating a higher level of activity than she perceived.

The arbitrator concluded that the applicant did not meet the stringent post-156 week test under subsection 13(8)(b) of the Schedule, as her impairment did not continuously prevent her from engaging in substantially all of her former activities.

The application for weekly benefits was dismissed.

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

She applied for ongoing weekly income benefits, arguing she suffered from post-concussion syndrome and a brain injury that prevented her from working.

The insurer argued her inability to work was due to pre-existing psychological conditions and post-accident life events.

The arbitrator found that the accident materially contributed to her disability, exacerbating a pre-existing personality disorder, and that she was continuously prevented from engaging in suitable employment.

The arbitrator also ordered a $5,000 special award against the insurer for unreasonably terminating and withholding benefits based on a cursory neurological report while ignoring numerous other medical recommendations.

The applicant was injured in a rear-end motor vehicle accident and received weekly income benefits for three years.

He applied for ongoing benefits, claiming physical and psychological disability prevented him from working.

The arbitrator found that while the applicant suffered a herniated disc from the accident, he exaggerated his symptoms and his psychological condition was caused by pre-existing and psycho-social factors unrelated to the accident.

The arbitrator concluded the applicant retained the capacity and skills for suitable employment, such as a retail clerk or in construction trades, and dismissed the claim for ongoing benefits.

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

He applied for arbitration seeking ongoing weekly income benefits and supplementary medical and rehabilitation expenses.

The arbitrator found that the applicant was reasonably suited for teaching and thus not entitled to ongoing income benefits under section 12(5)(b), except for a six-month recovery period following back surgery.

The arbitrator also awarded limited case management services and a six-month diet program, but denied a special award, finding the insurer had not unreasonably withheld payments.