Dr. S. Sober

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

The applicant sought further income replacement benefits, arguing he was unable to return to his pre-accident employment as a concrete cutter due to physical and psychological impairments.

The arbitrator found the applicant's physical impairment evidence unreliable, but accepted the psychological evidence that he suffered from major depressive disorder and anxiety which prevented him from working.

The arbitrator preferred the applicant's psychological expert over the insurer's expert.

The applicant was awarded income replacement benefits for the disputed period.

Claims for attendant care and housekeeping were withdrawn, and a claim for the cost of a functional abilities evaluation was denied for failing to seek prior approval.

The applicant sought income replacement benefits (IRBs) and other expenses following a 1995 motor vehicle accident.

The insurer reduced and then terminated the IRBs, and sought repayment of all benefits paid, alleging fraud.

The arbitrator found that the applicant had fabricated his employment history, concealed a previous disabling car accident, and grossly exaggerated his injuries, with medical evidence suggesting malingering.

The applicant's claims were dismissed in their entirety.

The arbitrator ordered the applicant to repay $37,879 in IRBs and rehabilitation expenses obtained through fraudulent misrepresentation, and awarded the insurer its arbitration expenses and assessment fee, finding the application frivolous and an abuse of process.