Dr. V. Hajek

The applicant was injured in a motor vehicle accident and claimed ongoing income replacement benefits (IRBs) and medical rehabilitation benefits.

The arbitrator determined that the applicant was an independent contractor, not an employee, and calculated her pre-accident income accordingly, resulting in a lower IRB rate.

The arbitrator found insufficient medical evidence to support a substantial inability to perform the essential tasks of her employment beyond the insurer's termination date.

Consequently, the applicant was ordered to repay the insurer for the overpayment of IRBs.

However, the insurer was ordered to pay for outstanding physiotherapy treatments, which were found to be reasonable and necessary.

The appellant appealed an arbitrator's decision upholding the termination of his weekly income benefits at the 156-week mark by the respondent insurer.

The central issue was whether the appellant met the disability test under section 12(5)(b) of the Statutory Accident Benefits Schedule, which requires that the injury continuously prevents the insured from engaging in any suitable occupation.

The appellant argued that the arbitrator erred in relying on the evidence of his treating physiatrist, who testified for the insurer, and in finding that suitable work was available.

The Director's Delegate dismissed the appeal, finding no error in the arbitrator's reliance on the physiatrist's evidence or the conclusion that the appellant was capable of light or sedentary work.

The appellant was awarded his reasonable appeal expenses.