2 total
Application for post-156 week income benefits dismissed; applicant failed to prove inability to perform any suitable employment.
The applicant was injured in a motor vehicle accident and received weekly income benefits for 156 weeks.
The insurer terminated benefits, arguing the applicant no longer met the stricter disability test under section 12(5)(b) of the Statutory Accident Benefits Schedule.
The arbitrator found that while the applicant suffered from chronic back pain and might be disabled from his pre-accident heavy manual job, he failed to prove that his injuries continuously prevented him from engaging in any occupation or employment for which he was reasonably suited by education, training, or experience.
The application for further weekly income benefits was dismissed, but the insurer was ordered to pay the applicant's arbitration expenses.
Claim for post-156 week income benefits dismissed as surveillance and psychological evidence showed applicant could work.
The applicant was injured in a motor vehicle accident and received statutory accident benefits, including weekly income benefits, for three years.
The insurer terminated benefits after 156 weeks.
The applicant sought ongoing benefits under section 12(5)(b) of the Schedule, claiming chronic pain and sciatica prevented her from working.
The arbitrator found that surveillance evidence and psychological assessments contradicted the applicant's claims of severe pain and inability to work.
The arbitrator concluded the applicant was exaggerating her symptoms and was physically and psychologically capable of resuming office work.
The claim for ongoing weekly benefits was dismissed, but the applicant was awarded the expenses of the arbitration.
No co-appearing lawyers found.
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