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Insurer ordered to pay ongoing income replacement and partial housekeeping benefits due to accident-related psychological impairments.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including income replacement, housekeeping, and attendant care benefits, which the insurer had terminated.
The insurer argued the applicant had removed herself from the workforce prior to the accident due to pre-existing psychological issues.
The arbitrator applied the material contribution test and found that the accident materially contributed to the applicant's pain disorder and exacerbated her depression and anxiety, resulting in a complete inability to engage in employment.
The arbitrator awarded ongoing income replacement benefits and partial housekeeping benefits, but denied attendant care benefits and a special award, finding the insurer's reliance on its medical assessments was not unreasonable.
Income replacement benefits and special award granted where insurer unreasonably ignored psychological evidence of chronic pain.
The applicant was struck by a vehicle while walking across an intersection and sustained physical and psychological injuries.
The insurer terminated her income replacement benefits based on an orthopaedic assessment.
The applicant sought arbitration, arguing she suffered from chronic pain with a significant psychological component that prevented her from working.
The arbitrator found that the applicant was completely unable to engage in any employment for which she was reasonably suited, preferring the evidence of her psychological experts over the insurer's assessors.
The arbitrator also granted a special award, finding that the insurer unreasonably withheld benefits by misfiling and ignoring a key psychological report that supported her claim.
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