Dr. Resnick

The Applicant was injured in a motor vehicle accident and sought statutory accident benefits, including an Income Replacement Benefit (IRB) beyond the 104-week mark and a Medical Treatment Plan.

The Insurer denied the benefits.

The Arbitrator found that the Applicant did not meet the "complete inability" test required for post-104 week IRBs, noting her history of working in a sedentary position and the availability of suitable alternative employment that would provide a higher income than her pre-accident earnings.

The Arbitrator also dismissed the claim for the Medical Treatment Plan, finding that the Applicant failed to prove it was reasonable and necessary, and did not contradict the Insurer's medical evidence that she had reached maximum therapeutic benefit.

The application was dismissed.

The applicant was injured in a motor vehicle accident and received care-giver benefits until the insurer terminated them at the 104-week mark.

The applicant applied for arbitration, arguing she suffered a complete inability to carry on a normal life.

The arbitrator found that the applicant's physical injuries, chronic pain, and severe depression continuously prevented her from engaging in substantially all of her pre-accident activities.

The arbitrator ordered the insurer to pay ongoing care-giver benefits and interest, but denied the applicant's request for a special award, finding no evidence that the insurer unreasonably withheld payments.