4 total
Application for income replacement and medical benefits dismissed; applicant failed to prove inability to work.
The applicant sought Income Replacement Benefits (IRBs) and medical benefits following a rear-end motor vehicle accident.
The insurer denied the claims, arguing the applicant did not suffer a substantial or complete inability to work and that the medical treatments were not reasonable and necessary.
The arbitrator found that the applicant continued to work for 14 months post-accident and that her subsequent medical complaints, including blackouts and incontinence, were not causally linked to the accident by the medical experts.
The arbitrator dismissed the application, concluding the applicant failed to prove entitlement to IRBs, medical benefits, or a special award.
Accident benefits claim largely dismissed due to exaggerated symptoms shown on surveillance; minor treatment and special award granted.
The applicant, a public transit passenger, sought statutory accident benefits for soft tissue injuries sustained when his streetcar collided with a truck.
He claimed over $13,000 for chiropractic treatment and the cost of an examination report.
The arbitrator found that the applicant significantly exaggerated his injuries, relying on surveillance evidence that contradicted his severe complaints.
The treating chiropractor's evidence was rejected as unreliable.
However, based on an independent assessment recommendation, the arbitrator awarded $380 for four treatment sessions.
A $200 special award was also granted because the insurer unreasonably denied payment for those four recommended sessions.
Accident benefits denied and repayment ordered due to applicant's misrepresentation of employment and pre-existing injuries.
The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to weekly income benefits and rehabilitation expenses.
The insurer terminated benefits and sought repayment, alleging the applicant was not employed at the time of the accident and misrepresented his condition.
The arbitrator found the applicant lacked credibility, having concealed a pre-existing work-related knee injury and a prior severe head injury from both the insurer and medical assessors.
The arbitrator concluded the applicant was not employed at the time of the accident and did not suffer an ongoing disability caused by the accident.
The applicant's claims were dismissed, and the insurer was granted repayment of the weekly income benefits paid, as they were induced by the applicant's culpable error and failed to account for deductible workers' compensation benefits.
Arbitrator calculates self-employed plumber's income benefits and terminates them based on surveillance and medical evidence.
The applicant, a self-employed plumber, was injured in a motor vehicle accident and claimed statutory accident benefits.
The insurer paid weekly income benefits at the minimum level and later terminated them, arguing the applicant was no longer disabled.
The arbitrator found the applicant's evidence regarding his pre-accident income to be unreliable and calculated his weekly income benefit based on corroborated work performed in the four weeks prior to the accident.
Relying on medical assessments and video surveillance showing the applicant playing softball, the arbitrator concluded he was capable of returning to work by December 1993 and denied benefits beyond February 1994.
The insurer was permitted to deduct post-accident employment income but was denied repayment of benefits previously paid.
Claims for transportation expenses for swimming were partially allowed, while claims for damaged clothing and a special award were dismissed.
Expenses of the arbitration were denied due to the applicant's misleading evidence.
No linked lawyers found.
No linked judges found.