5 total
Arbitrator reduced excessive clinic fees and treatment frequency for accident benefits claim following tibia fracture.
The applicant was struck by a vehicle and sustained a fractured tibia.
She sought statutory accident benefits for chiropractic and active rehabilitation therapy.
The insurer disputed the reasonableness of the treatment and the fees charged by the clinics.
The arbitrator found that the treatment was reasonable and necessary to assist in the applicant's recovery, but determined that the frequency and duration of the treatments, as well as the fees charged by the clinics, were excessive.
The arbitrator reduced the compensable sessions and the hourly rates, awarding $1,080.50 for chiropractic expenses and $635 for rehabilitation expenses, plus interest.
Arbitrator awards interim income replacement benefits and housekeeping expenses pending a valid DAC assessment report.
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.
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 weekly income benefits dismissed due to pre-existing injury; limited physiotherapy expenses awarded.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including weekly income benefits and the cost of physiotherapy and transportation.
The insurer denied benefits, arguing that the applicant's disabilities arose from a previous work-related injury for which she was receiving WCB benefits.
The arbitrator found that the applicant's pre-existing back injury was the principal cause of her inability to work, and dismissed the claim for weekly income benefits.
However, the arbitrator found it was reasonable for the applicant to undergo an initial 12-week physiotherapy program to alleviate neck symptoms, and ordered the insurer to pay for those treatments and associated transportation costs.
The applicant was awarded 50 percent of her arbitration expenses.
Applicant awarded ongoing weekly income benefits after 156 weeks due to continuous physical and psychological disability.
The applicant was injured in a motorcycle accident and received statutory accident benefits until the insurer terminated his weekly income benefits after 156 weeks.
The applicant applied for arbitration, claiming ongoing entitlement to weekly income benefits, additional medical and rehabilitation expenses, and a special award for unreasonable delay.
The arbitrator found that the applicant's physical and psychological limitations continuously prevented him from engaging in any suitable employment, entitling him to ongoing weekly income benefits.
The arbitrator also awarded costs for an adjustable bed and necessary child care, but denied claims for a whirlpool, scooter, and other items.
The claim for a special award was dismissed as the insurer's delays were largely attributable to the applicant's own conduct and unreasonable demands.
No co-appearing lawyers found.
No judges found.