Dr. Y.K. Goldberg

The applicant was injured in a motor vehicle accident and sought ongoing income replacement benefits (IRBs) beyond the 104-week mark, claiming she was completely unable to work due to a temporomandibular joint disorder (TMD) and chronic pain.

The insurer argued the TMD was caused by pre-existing bruxism and stress, not the accident, and that she was not disabled from working.

The arbitrator found the applicant's testimony credible, concluded the accident materially contributed to her TMD, and determined she met the test for post-104 week IRBs.

Claims for a specific dental assessment cost and a special award were dismissed, but the applicant was awarded her arbitration expenses and interest on overdue benefits.

The applicant sought interim payment of dental and chiropractic accounts under the 'pay pending dispute' provisions of the Statutory Accident Benefits Schedule following a 1993 motor vehicle accident.

The insurer moved to dismiss the arbitration as duplicitous with the applicant's civil action and sought to introduce defence medical reports obtained in that action.

The arbitrator admitted the medical reports, finding the interests of justice outweighed the deemed undertaking rule, but refused to dismiss the arbitration, holding the claims were distinct.

The arbitrator ordered the insurer to pay the medical accounts on an interim basis, finding the applicant had established the requisite de minimis connection between the accident and the treatment.