Dr. G.M. Annisette

The appellant was injured in a motor vehicle accident and claimed income replacement benefits.

The insurer terminated benefits based on medical assessments indicating the appellant could return to work.

The arbitrator dismissed the appellant's claim for ongoing benefits, finding he was not substantially unable to perform the essential tasks of his self-employment in construction, and calculated a reduced benefit rate based on estimated business expenses.

On appeal, the Director's Delegate upheld the arbitrator's decision, finding no error in the assessment of the expert medical evidence or the pragmatic calculation of the appellant's self-employment income.

The applicant, a 62-year-old labourer with a grade three education, was struck by a motor vehicle and suffered multiple injuries, including fractured ribs and a head injury.

He applied for ongoing weekly income benefits under section 12(5)(b) of the Statutory Accident Benefits Schedule after the insurer terminated them.

The arbitrator found that the applicant suffered from post-concussion syndrome and chronic disabling pain resulting from the accident.

Given his age, limited education, poor English skills, and physical limitations, the arbitrator concluded that the applicant was continuously prevented from engaging in any suitable occupation or employment.

The insurer was ordered to pay weekly income benefits of $536.75 from May 5, 1994 onwards, plus interest and expenses.

The applicant was injured in a motor vehicle accident and received weekly accident benefits until the insurer terminated them, arguing she was capable of returning to work.

The applicant applied for arbitration, claiming ongoing disability from her two pre-accident jobs as a housekeeping aid and a chiropractic assistant.

The arbitrator found that while the applicant could likely perform the chiropractic assistant role, she remained substantially disabled from the physical demands of the housekeeping job due to accident-related lower back pain.

The arbitrator ordered the reinstatement of weekly benefits, along with interest on overdue payments.

Additionally, the arbitrator granted a $2,000 special award against the insurer for unreasonably delaying initial benefit payments without providing required notice, and awarded the applicant her arbitration expenses.