Dr. R.D. Kaplan

The applicant, who was injured in a motor vehicle accident, sought interim benefits for psychological treatment pending the arbitration hearing.

The insurer opposed the request, relying on an assessment that suggested symptom exaggeration.

The arbitrator applied the test for interim benefits, requiring a prima facie case of entitlement along with need or urgency.

Relying on the evidence of the applicant's treating psychologists, which documented severe depression, suicidal and homicidal ideation, and a risk of harm to himself and others, the arbitrator found that the applicant met the test.

The insurer was ordered to pay $5,953.46 for sixteen sessions of psychological treatment.

The applicant was injured in two motor vehicle accidents and received statutory accident benefits until the insurer terminated them in January 1994.

The applicant sought ongoing weekly income benefits, medical and rehabilitation benefits, and a special award, claiming he was unable to return to his pre-accident job as a welder due to thoracic outlet syndrome and other injuries.

The arbitrator dismissed the application, finding that the applicant's ongoing difficulties were primarily related to pre-existing, work-related conditions rather than the motor vehicle accidents.

Surveillance evidence and the applicant's post-accident recreational activities demonstrated a level of functional ability inconsistent with his claims of severe disability.

The insurer's termination of benefits was deemed reasonable, and no special award was granted.