2 total
Arbitration order denying income benefits rescinded due to factual errors undermining adverse credibility findings.
The appellant was injured in a motor vehicle accident and claimed weekly income benefits for chronic pain and depression.
The arbitrator denied the claim, finding the appellant not credible based on alleged pre-existing conditions, surveillance evidence, and hearing observations.
On appeal, the Director's Delegate found that the arbitrator made serious factual errors regarding the pre-accident medical records and misapprehended the surveillance evidence.
Because these errors undermined the core credibility findings, the appeal was allowed, the arbitration order was rescinded, and the matter was remitted for a new hearing before a different arbitrator.
Post-156 week income benefits terminated after brief work-hardening extension due to symptom embellishment and residual capacity.
The applicant was injured in a motor vehicle accident and received statutory accident benefits for 156 weeks.
The insurer terminated weekly income benefits at the three-year mark.
The applicant sought ongoing benefits under section 12(5) of the Schedule, claiming continuous inability to engage in suitable employment due to soft tissue injuries, fibromyalgia, and depression.
The arbitrator found evidence of symptom embellishment and concluded the applicant was capable of sedentary work or returning to his previous administrative courier duties.
The arbitrator awarded a brief extension of benefits for a four-month 'work hardening' period, terminating on January 29, 1994.
No co-appearing lawyers found.
No judges found.