Dr. P. Kirwin

The applicant was injured in a motor vehicle accident and received income replacement benefits until they were terminated by the insurer.

The applicant brought a motion for interim income replacement benefits pending the final arbitration hearing.

The arbitrator found that the applicant established a prima facie case for post-104 week income replacement benefits based on medical evidence of chronic pain and fibromyalgia.

The applicant also demonstrated financial need.

The motion was granted, and the insurer was ordered to pay interim benefits of $400 per week.

Arbitration under the Statutory Accident Benefits Schedule concerning ongoing income replacement benefits after a motor vehicle accident.

The arbitrator found that the applicant met the own-occupation disability test up to the two-year anniversary of the accident, largely on the strength of two functional capacity evaluations that were not effectively undermined by the insurer.

The insurer's orthopaedic expert was given little weight because his analysis focused unduly on objective findings and failed to address the functional demands of the pre-accident job.

The applicant failed, however, to prove the stricter post-104 week any-occupation test.

Issues of prejudgment interest, special award, and legal expenses were left for further submissions.

The applicant was injured in two motor vehicle accidents in 1995 and sought ongoing income replacement benefits (IRBs) and rehabilitation benefits from the insurer.

The arbitrator found that the applicant had a legitimate contract of employment as a truck driver trainee prior to the second accident and was substantially unable to perform the essential tasks of that employment due to injuries sustained in the accident, specifically heterotopic bone formation affecting his ability to sit for prolonged periods.

The applicant was awarded IRBs based on the truck driving contract, as well as funding for a vocational assessment at Goodwill Industries and case management services.

The applicant's claim for a higher IRB rate based on his pre-accident work as a taxi driver was dismissed due to a lack of reliable income evidence.

The applicant sought statutory accident benefits after being struck by a van at a self-storage facility.

The insurer denied benefits, arguing the incident was not an 'accident' and the application was out of time.

The arbitrator found the incident met the Amos test for an accident and the applicant had a reasonable excuse for the delay.

The applicant was awarded income replacement benefits for a closed period, but claims for supplementary medical and housekeeping expenses were dismissed, with the arbitrator finding the housekeeping receipts were fabricated.