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Ongoing income replacement benefits awarded to injured welder who met the post-104 week disability test.
The applicant was injured in a motor vehicle accident and received statutory accident benefits, including income replacement benefits (IRBs), which the insurer terminated after approximately 21 months.
The applicant sought ongoing IRBs under both the pre-104 week 'own occupation' test and the post-104 week 'any occupation' test.
The arbitrator found that the applicant sustained significant orthopaedic injuries, particularly to his right hip and left hand, which prevented him from performing the heavy physical demands of his pre-accident employment as a welder.
Furthermore, given the applicant's limited English proficiency and lack of transferable skills, the arbitrator concluded he suffered a complete inability to engage in any employment for which he was reasonably suited by education, training, or experience.
The applicant was awarded ongoing IRBs and interest, but his claim for a special award was dismissed as the insurer's reliance on its medical assessments was not unreasonable.
Claim for ongoing weekly income benefits dismissed; applicant ordered to repay overpaid benefits.
The Applicant was injured in a motor vehicle accident and received weekly income benefits until they were terminated by the Insurer.
The Applicant sought ongoing benefits, claiming disability due to fibromyalgia and chronic pain.
The arbitrator found that the Applicant did not suffer from a substantial disability preventing her from returning to her pre-accident employment as a legal secretary, noting a lack of objective medical evidence, failure to participate in active rehabilitation, and an adverse inference drawn from her failure to testify.
The Applicant's claim for ongoing benefits was dismissed, and she was ordered to repay $1,797 in overpaid benefits due to her failure to provide timely notice of post-accident income.
The Applicant was awarded one-third of her arbitration expenses.
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