Dr. Howard Seiden

The applicant sought a determination that she sustained a catastrophic impairment as a result of a 2018 motor vehicle accident, along with entitlement to a physiotherapy treatment plan, an award, and interest.

The adjudicator found that the applicant failed to prove she met the criteria for catastrophic impairment under Criteria 6 (physical), 7 (combined physical and psychological), or 8 (mental/behavioural).

The adjudicator rejected the applicant's expert evidence, finding it inconsistent with the AMA Guides and unsupported by objective medical evidence.

The claim for the physiotherapy treatment plan was also dismissed as the applicant failed to include the plan in evidence or prove it was reasonable and necessary.

Consequently, the claims for an award and interest were dismissed.

The applicant sought accident benefits after a vehicle crashed into her home, causing her severe psychological and cognitive decline.

The insurer sought to stay the arbitration until the applicant attended further insurer examinations (IEs) under section 44 of the Schedule.

The applicant sought interim benefits.

The arbitrator dismissed the insurer's request for a stay, finding that further IEs would not assist the insurer and were not reasonably necessary given the unopposed expert evidence that further assessments risked causing the applicant serious psychological deterioration.

The arbitrator granted the applicant's request for interim benefits in part, awarding $7,000 for past medical expenses based on a demonstrated prima facie case, financial need, and urgency.

The insurer appealed an arbitration decision that excluded the evidence of a replacement medical expert and ordered a $40,000 special award for unreasonably delaying and withholding income replacement benefits.

The Director's Delegate upheld the exclusion of the replacement expert's evidence, finding no error of law.

While the Delegate agreed that the insurer unreasonably delayed and withheld benefits, he found the arbitrator erred in calculating the special award by applying it to post-104 week benefits based on a late-filed medical report the insurer had no time to consider.

The Delegate also found the arbitrator failed to consider mitigating factors and proportionality.

The special award was reduced to $10,000.

In a preliminary issue hearing for a statutory accident benefits arbitration, the insurer sought to admit the medical report of an expert who died before the hearing, as well as a critique report by a different doctor to stand in his place.

The arbitrator admitted the deceased doctor's report, noting it was prepared at a crucial time when benefits were terminated and no other examination could be obtained, though its weight would be adjusted since he could not be cross-examined.

However, the arbitrator refused to admit the second doctor's report or allow him to testify, as there was no evidence he shared the same medical specialty as the deceased expert.

The applicant was injured in a motor vehicle accident and received income replacement benefits until the insurer terminated them on July 9, 1998.

The applicant sought arbitration, claiming ongoing physical and psychological impairments prevented him from returning to his pre-accident employment as a cabinet assembler.

The arbitrator found that the applicant's physical soft tissue injuries had resolved and that he magnified his physical symptoms.

However, the arbitrator accepted that the applicant suffered from depression, anxiety, and pain-focused behavior that disabled him from working.

The arbitrator concluded that the applicant's failure to attend recommended psychological treatment and exercise hampered his recovery, and that by December 9, 1998, his ongoing inability to work was due to his own choice not to rehabilitate himself.

Income replacement benefits were awarded for the period from July 9, 1998, to December 9, 1998.

The Applicant was injured in a motor vehicle accident and received statutory accident benefits.

The Insurer terminated weekly income benefits, and the parties proceeded to arbitration.

The arbitrator found that the Applicant's physical injuries had largely resolved, but she continued to suffer a substantial inability to perform the essential tasks of her occupation due to psychological injuries until March 24, 1993.

The Applicant was awarded weekly income benefits up to that date, as well as supplementary medical and rehabilitation benefits for her residual psychological injuries.

The Insurer was entitled to repayment of weekly income benefits paid after March 24, 1993.

The applicant was injured in a motorcycle accident and sought no-fault benefits to retrain as a commercial airline pilot, arguing he could no longer work as a truck driver due to knee injuries.

The arbitrator found that the applicant had successfully returned to work as a truck driver for a trial period and failed to provide medical evidence showing he could not continue in that occupation.

The arbitrator concluded that retraining as a pilot was not a reasonable expense resulting from the accident and dismissed the claim for occupational training benefits.

The Applicant sought weekly income benefits following a motor vehicle accident.

The Insurer terminated benefits on November 24, 1991.

The Arbitrator found that the Applicant failed to prove a substantial inability to perform the essential tasks of his employment after that date.

Furthermore, the Arbitrator determined that the Applicant attempted to defraud the Insurer by claiming to be the beneficial owner of a business to inflate his pre-accident income.

The correct weekly income benefit was calculated based solely on his actual employment income.

As a result, the Applicant was ordered to repay an overpayment of $12,682.82 plus interest to the Insurer, and his claim for arbitration expenses was denied due to his fraudulent conduct.