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Applicant found substantially disabled and entitled to ongoing weekly income benefits calculated as self-employment income.
The applicant was injured in a motor vehicle accident and received weekly income benefits until the insurer terminated them, claiming he was no longer substantially disabled from his pre-accident employment as a drywall installer and glazier.
The arbitrator found the applicant's complaints of chronic pain to be genuine and supported by medical evidence, concluding he remained substantially disabled.
The arbitrator also determined the applicant was self-employed rather than an employee, requiring a recalculation of his weekly income benefits by deducting ceasing business expenses.
The insurer was ordered to pay ongoing benefits at a reduced rate, and the applicant was ordered to repay the resulting overpayment from the initial period.
Insured entitled to ongoing weekly income benefits during vocational retraining due to accident-related physical limitations.
The applicant was injured in a motor vehicle accident and received statutory accident benefits.
The insurer terminated his weekly income benefits three years post-accident.
The applicant sought further benefits under section 12(5)(b) of the Schedule, claiming he required extensive retraining due to his physical limitations.
The insurer argued the applicant was magnifying his disability and could return to his previous work as a brick mason.
The arbitrator found that the applicant's realistic work tolerances fell below the medium to heavy range required for his pre-accident job, but that his rehabilitation efforts and improved English skills opened new employment opportunities.
The arbitrator ordered the insurer to pay weekly income benefits from the date of termination until the conclusion of a pre-examination community college course the applicant had started.
No co-appearing lawyers found.
No judges found.