Dr. Gary Lee

The applicant, a self-employed locksmith, was injured in a motor vehicle accident in 2000 and received income replacement benefits (IRBs) until the insurer terminated them in 2006.

The applicant sought post-104 week IRBs, arguing he suffered a complete inability to engage in any employment for which he was reasonably suited.

The arbitrator found the applicant credible and accepted that his chronic pain syndrome prevented him from working an eight-hour day on a full-time basis.

The insurer's experts failed to consider whether the applicant could sustain full-time hours in a structured employment setting.

The arbitrator also dismissed the insurer's request to set off alleged past overpayments against future IRBs, as the insurer had not followed the statutory notice and repayment scheme under section 47 of the Schedule.

The applicant was awarded IRBs of $185.00 per week from March 2006 onward.

The applicant was injured in a motor vehicle accident while riding his bicycle.

The insurer paid income replacement benefits for 104 weeks but terminated them, arguing the applicant did not meet the more stringent test of complete inability to engage in suitable employment.

The arbitrator found the applicant, who was functionally illiterate in English and had a history of heavy physical labour, suffered from chronic pain and psychological impairments caused by the accident.

The arbitrator rejected the insurer's expert evidence that the applicant was malingering, finding instead that he was completely disabled from working.

The applicant was awarded ongoing income replacement benefits.

However, his claim for a multidisciplinary pain management program was dismissed as he failed to prove it was reasonable and necessary, given a previous similar program had not yielded further recovery.