25 total
Application for income replacement benefits dismissed because applicant's post-accident self-employment income reduced entitlement to zero.
The applicant sought income replacement benefits (IRBs) following a motor vehicle accident, claiming he was unable to work and that his business income was passive.
The insurer argued the applicant returned to work immediately, continued to operate his property development business, and earned income exceeding any IRB entitlement.
The arbitrator found that the applicant continued to perform his pre-accident duties, earned substantial post-accident income, and deliberately failed to produce his company's general ledger.
The application for IRBs was dismissed, as the post-accident income reduced the IRB entitlement to zero.
Insurer ordered to pay income replacement benefits and a $10,000 special award for unreasonably withholding payments.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including income replacement benefits (IRBs), transportation expenses, and the cost of a medical assessment.
The insurer denied the benefits, arguing the applicant had returned to work and did not meet the disability tests.
The arbitrator found the applicant suffered a substantial inability to perform her pre-accident employment for the first 104 weeks and a complete inability to engage in suitable employment thereafter until she commenced a new career.
The arbitrator awarded the IRBs, transportation expenses, and assessment costs.
Furthermore, the arbitrator ordered the insurer to pay a $10,000 special award because it unreasonably withheld IRBs by failing to have its accountant review updated financial information that would have revealed flaws in its initial denial.
Arbitrator determines loss of earning capacity and awards housekeeping expenses but denies shop assistant claim.
The applicant was injured in a motor vehicle accident and claimed statutory accident benefits, including a loss of earning capacity (LEC) benefit, housekeeping expenses, and shop assistant expenses.
The arbitrator determined the applicant's pre-accident earning capacity based on her reported income and unreported tips, and found she had no residual earning capacity due to a mild to moderate brain injury.
The claim for a shop assistant was dismissed as an unreasonable rehabilitation expense, while the claim for housekeeping expenses was allowed.
The applicant's request for a special award was dismissed.
Barter arrangement for accommodation constitutes employment for the purpose of statutory accident benefits.
The applicant was injured in a motor vehicle accident and claimed income replacement benefits for his employment as a bus driver and for a separate arrangement where he provided landscaping services in exchange for free accommodation.
The insurer terminated benefits, arguing the applicant was not substantially disabled from his bus driver position and that the landscaping arrangement did not constitute employment.
The arbitrator found that the applicant suffered a substantial inability to perform the essential tasks of both jobs due to his back impairment and reduced tolerance for prolonged sitting.
The arbitrator also held that the barter arrangement for accommodation constituted employment under the Schedule.
The applicant was awarded income replacement benefits for both employments, subject to deductions for collateral benefits and post-accident income, as well as his arbitration expenses.
Ex gratia retirement payment included in death benefit income calculation; accrued sick leave payout excluded.
The applicant claimed death benefits following her husband's fatal car accident.
The dispute centered on whether an ex gratia payment and a sick leave payout received by the deceased upon his retirement, within the 156 weeks preceding the accident, should be included as income for calculating the death benefit.
The arbitrator held that the purely discretionary ex gratia payment was income earned upon retirement and thus included in the calculation.
However, the sick leave payout accrued steadily throughout the deceased's employment and was not included as income within the 156-week period.