Dr. Ronald Gitelman

The applicant was injured in a motor vehicle accident while enrolled in a heavy duty equipment mechanic college program.

The insurer terminated his weekly education disability benefits.

The applicant sought arbitration, claiming he was physically and mentally unable to complete his education due to chronic pain and depression.

The arbitrator dismissed the claim, finding that the applicant's physical injuries were primarily soft tissue and had resolved, as evidenced by his subsequent employment in physically demanding jobs and his weight training.

The arbitrator also found no persuasive medical evidence of a disabling psychiatric condition or head injury, concluding the applicant failed to prove a substantial inability to complete his education or carry on a normal life.

The applicant was injured in a motor vehicle accident and sought ongoing income replacement benefits and supplementary medical benefits for prescriptions after the insurer terminated them.

The arbitrator found that the applicant was not physically disabled from returning to her pre-accident employment as a hairstyling instructor.

However, the arbitrator concluded that the applicant suffered from accident-related panic attacks that substantially disabled her from working during an acute phase between December 1996 and August 1997.

Income replacement benefits were awarded for this limited period.

The arbitrator also awarded the cost of most claimed prescriptions, finding them reasonable and necessary for treating her accident-related psychological condition.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including income replacement benefits, physiotherapy expenses, and the cost of a psychological assessment.

The insurer terminated benefits, arguing the applicant could return to his work as a piece-work upholsterer.

The arbitrator found that the applicant suffered from post-traumatic stress disorder and residual physical problems that substantially disabled him from performing the high-speed, repetitive tasks of his employment.

The arbitrator ordered the insurer to pay the claimed benefits, along with a special award under section 282(10) of the Insurance Act for unreasonably withholding payments.

The complainant, who was diagnosed as HIV-positive shortly after commencing employment, was denied long-term disability benefits due to a pre-existing condition exclusion clause in the employer's group insurance policy.

The clause excluded coverage for disabilities arising from conditions for which the employee received medical care during the 90-day probationary period.

The Board of Inquiry found that while the clause was prima facie discriminatory, it was saved by section 25(3)(a) of the Human Rights Code as a reasonable and bona fide distinction based on a pre-existing handicap that substantially increases risk.

The Board applied the Supreme Court's test from Zurich Insurance, concluding the clause was a sound and accepted insurance practice for small groups to prevent adverse selection, and that no practical alternative existed.