Dr. John Darracott

The appellant appealed an arbitration decision denying her claim for weekly income benefits following a motor vehicle accident.

The arbitrator had concluded that the appellant's symptoms were not substantially disabling, relying in part on observations of the appellant sitting for long periods during the hearing, which contradicted her subjective complaints to her doctors.

On appeal, the appellant argued the arbitrator erred by relying on these observations.

The Director's Delegate dismissed the appeal, finding that the arbitrator made appropriate use of her observations to evaluate the accuracy of the subjective complaints underlying the medical opinions.

The appellant was awarded $750 in appeal expenses because the appeal raised an important issue regarding an arbitrator's ability to observe and consider physical capacity during a hearing.

The applicant was injured in a motor vehicle accident and received statutory accident benefits for eight weeks.

He subsequently sought ongoing weekly income benefits and rehabilitation services, claiming he was disabled by soft tissue injuries and a fractured elbow.

The arbitrator found the applicant's testimony lacked credibility, noting discrepancies in his reported income, his failure to report his return to work, and his regular participation in sports like golf and snooker.

The arbitrator concluded the applicant was not disabled after September 4, 1992, and denied further benefits.

Furthermore, because the applicant had overstated his pre-accident income, the insurer was entitled to repayment of $1,075.20 in overpaid benefits.

Both parties' claims for arbitration expenses were dismissed.

The applicant was injured in a motor vehicle accident and received weekly income benefits until they were terminated by the insurer.

The applicant sought reinstatement of benefits under section 12(1) of the Schedule for the period up to 156 weeks post-accident, and under section 12(5)(b) thereafter.

The arbitrator found that the applicant was substantially unable to perform the essential tasks of her pre-accident employment as a sewing machine operator due to the demanding nature of the job and uncertainty about her capacity, granting benefits up to the 156-week mark.

However, the arbitrator dismissed the claim for ongoing benefits after 156 weeks, finding that the applicant was not continuously prevented from engaging in any occupation or employment for which she was reasonably suited, as she was capable of other light industrial work.

The insurer brought a preliminary issue motion arguing that the insured was precluded from proceeding with his arbitration for ongoing weekly income benefits because he refused to attend a medical examination.

The insured argued that the insurer's right to require a medical examination ended when it terminated his benefits.

The arbitrator held that section 23(2) of the Statutory Accident Benefits Schedule allows an insurer to require a medical examination to evaluate an ongoing claim even after benefits have been terminated.

The arbitrator found the insurer's request for a follow-up examination reasonable and ordered that the insured is precluded from proceeding with the arbitration unless he makes himself reasonably available for the examination.

The applicant was injured in a rear-end motor vehicle accident and received weekly income benefits until the insurer terminated them.

The applicant sought arbitration, claiming she suffered from post-traumatic fibromyalgia and was substantially unable to perform her essential job tasks as an assembler.

The arbitrator reviewed medical evidence and surveillance video, concluding that the applicant's job was light and sedentary, and that she had adopted a dysfunctional stance, magnifying her symptoms.

The arbitrator found that any continuing symptoms were not caused by the accident and dismissed the claim for ongoing weekly income benefits and a special award, but granted the applicant her arbitration expenses.

The applicant was injured when her car door fell off its hinges.

She received weekly income benefits until the insurer terminated them based on medical reports indicating she could return to work.

The applicant sought arbitration, claiming ongoing chronic pain prevented her from performing her job as an accounts receivable clerk.

The arbitrator dismissed the claim, finding the medical evidence did not support a causal link between the minor trauma and her ongoing complaints.

Furthermore, video surveillance evidence contradicted her claims of physical limitation, leading the arbitrator to conclude she had not established a substantial inability to perform the essential tasks of her employment.