Dr. Michael Hall

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 sought statutory accident benefits following a motor vehicle accident.

The applicant failed to attend the arbitration hearing, and the arbitrator proceeded in his absence.

Based on the uncontroverted evidence from the insurer, including medical assessments indicating the applicant sustained no injuries and was exaggerating symptoms, and evidence that the applicant was working as a construction labourer while receiving income replacement benefits, the arbitrator dismissed the claims for ongoing benefits.

The arbitrator ordered the applicant to repay $1,897.86 in benefits previously paid due to wilful misrepresentation.

The insurer was awarded $500 in expenses, but its request for repayment of the assessment fee under section 282(11.2) of the Insurance Act was denied as the proceeding was not found to be frivolous, vexatious, or an abuse of process.

The applicant was injured in a motorcycle accident, suffering severe fractures to his left thumb.

The insurer terminated his weekly income benefits after two years, relying on an independent medical examination that concluded he could return to work.

The arbitrator found that the applicant, a welder who performed heavy manual labour, suffered a substantial inability to perform the essential tasks of his employment due to pain, weakness, and lack of sleep.

The arbitrator also found that the applicant was continuously prevented from engaging in any suitable occupation given his limited education, learning difficulties, and inability to cope with change.

The applicant was awarded ongoing weekly income benefits and interest, but his claim for a special award was dismissed as the insurer's decision to terminate benefits was based on conflicting medical reports and was not unreasonable.

The applicant was injured in a motor vehicle accident and received income replacement benefits until returning to heavy physical work.

Ten months later, he stopped working due to back pain and sought reinstatement of benefits, claiming the disability resulted from the accident.

The insurer denied the claim, arguing the new disability was a work-related repetitive strain injury.

The arbitrator agreed with the insurer on causation, dismissing the claim for income replacement benefits.

However, because the insurer unilaterally terminated payment for medical and rehabilitation treatments without following the mandatory dispute resolution procedures under the Statutory Accident Benefits Schedule, the arbitrator ordered the insurer to pay for those treatments up to the date it formally notified the providers of the negative assessment results, plus a 25% special award for unreasonable withholding.

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

She applied for arbitration, seeking ongoing weekly income benefits and medical/rehabilitation benefits.

The arbitrator found that the applicant suffered from chronic pain syndrome and remained disabled from her pre-accident job as an in-store demonstrator, entitling her to weekly benefits up to the 156-week mark.

However, the arbitrator concluded that the applicant was not continuously prevented from engaging in any suitable employment thereafter, and dismissed the claim for post-156 week benefits and further medical/rehabilitation benefits.

The applicant sought other disability benefits and medical and rehabilitation benefits following a motor vehicle accident.

The insurer denied the claims on the basis that the applicant did not suffer a partial or complete inability to carry on a normal life.

The arbitrator found that the applicant's medical difficulties pre-dated the accident and that he failed to present reliable evidence connecting his complaints to the collision.

The claims for benefits were dismissed.

Finding the arbitration to be frivolous, vexatious, and an abuse of process, the arbitrator ordered the applicant to pay $1,000 to the insurer under section 282(11.2) of the Insurance Act.

The applicant was injured in a motor vehicle accident while participating in a workers' compensation retraining program.

He claimed ongoing weekly income benefits under section 12 or 13 of the Statutory Accident Benefits Schedule.

The arbitrator found that the applicant was not employed by the Workers' Compensation Board and did not qualify under section 12.

However, the arbitrator concluded that the applicant suffered a substantial inability to perform his essential tasks as a student due to chronic pain and reflex sympathetic dystrophy, entitling him to ongoing benefits under section 13.

The claim for a special award was dismissed for lack of jurisdiction as it had not been mediated.

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

The Applicant applied for arbitration, claiming ongoing entitlement to weekly income benefits.

The Insurer relied on video surveillance and medical reports indicating the Applicant had recovered and was capable of returning to work.

The Arbitrator found that the Applicant's injuries had sufficiently healed by the termination date, noting that his reluctance to return to work was due to job dissatisfaction rather than physical disability.

The claim for ongoing benefits was dismissed, but the Applicant was awarded the expenses of the arbitration.

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

The applicant sought arbitration to reinstate the benefits and increase the weekly rate.

The arbitrator found that the applicant had a significant pre-existing back condition (ankylosing spondylitis) which he had concealed from medical examiners.

Due to inconsistencies and false evidence regarding his post-accident employment and pre-accident income, the arbitrator concluded the applicant failed to prove a substantial inability to perform his essential tasks.

The claim for further benefits was dismissed, the weekly rate was maintained at the statutory minimum, and no costs were awarded to either party.

The applicant was injured in a rear-end motor vehicle accident and received statutory accident benefits until they were terminated by the insurer.

More than a year after the accident, she was diagnosed with left shoulder rotator cuff tendonitis, which required surgery.

The insurer disputed that the shoulder condition was caused by the accident and argued the applicant was not disabled from her job as a cashier.

The arbitrator found that the shoulder condition was caused by the accident, likely due to the shoulder belt or traction effect, and that it rendered her substantially unable to perform the essential tasks of her employment.

The arbitrator awarded ongoing weekly income benefits, supplementary medical and rehabilitation expenses, and a special award for the insurer's unreasonable withholding of chiropractic expenses.

The applicant was injured in a motor vehicle accident and received weekly income benefits until the insurer terminated them, claiming she was no longer substantially unable to perform the essential tasks of her pre-accident employment as a server and cashier.

The arbitrator found that the applicant remained substantially unable to perform the heavy aspects of her work as a server and was therefore entitled to ongoing weekly income benefits.

The arbitrator also determined the proper calculation of her pre-accident income, including an estimate of her tip income, and awarded a special award of $1,500 against the insurer for unreasonably handling the tips issue.

The applicant sought ongoing weekly income benefits and a special award following a motor vehicle accident.

The insurer terminated benefits after an independent medical examination concluded the applicant's complaints were not genuine and he was fit to return to work.

The arbitrator dismissed the claim for ongoing benefits, finding the applicant's evidence lacked credibility due to his active concealment of a prior similar accident and exaggeration of his symptoms.

The claim for a special award was also dismissed, but the applicant was awarded his arbitration expenses because the claim was not manifestly frivolous.

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

The applicant sought ongoing benefits, while the insurer claimed he had returned to work as a self-employed leathercutter.

Relying on surveillance evidence and medical observations of calluses on the applicant's hands, the arbitrator found the applicant was working and able to perform his essential tasks by January 22, 1992.

The arbitrator also found the applicant had post-accident earnings that were deductible from his benefits.

The applicant was ordered to repay $26,125.36 in overpaid benefits, and his claims for expenses and a special award were dismissed due to his lack of credibility and pursuit of a claim despite clear evidence he was working.