Luigi Grimaldi

The applicant was injured in a motorcycle accident and sought post-104 income replacement benefits (IRBs) and an occupational therapy assessment.

The respondent insurer denied the benefits, arguing the applicant could work in alternative occupations.

The Tribunal found that the applicant, a 63-year-old self-employed hairdresser with significant physical, cognitive, and psychological impairments, suffered a complete inability to engage in suitable alternative employment.

The Tribunal awarded the IRBs and the cost of the occupational therapy assessment, along with interest.

The applicant's request for a special award under s. 10 of Regulation 664 and costs was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to income replacement benefits (IRBs) and a neurological assessment.

The Tribunal found that the applicant failed to prove she met the disability test for IRBs, as the medical evidence did not establish a substantial inability to perform the essential tasks of her self-employment.

However, because the respondent insurer issued deficient notices suspending and terminating the IRBs, the Tribunal ordered the respondent to pay IRBs totaling $9,783.83 for the period before a compliant notice was issued.

The claim for a neurological assessment was dismissed as not reasonable and necessary.

The Tribunal denied a special award but granted $500 in costs to the applicant due to the respondent's late service of an accounting report.

The applicant was injured in a 2018 motor vehicle accident and sought ongoing income replacement benefits (IRBs) beyond the 104-week mark, along with medical benefits, an award, and costs.

The respondent denied the IRBs, arguing the applicant could work part-time in alternative roles.

The Tribunal found that the applicant met the post-104 week test for IRBs because the alternative employment proposed by the respondent offered significantly less income and status than her pre-accident work, and her psychological impairments limited her to working only 6 to 10 hours per week.

However, the Tribunal dismissed the claims for metabolic testing, neuromonitoring, and physiotherapy due to insufficient evidence regarding their necessity and reasonable costs.

The claims for a special award and costs were also dismissed.

The Applicant was injured in a motor vehicle accident and sought statutory accident benefits from the Insurer, including income replacement benefits, attendant care benefits, and payment for various medical treatments and assessments.

The Arbitrator found that the Applicant suffered from chronic pain and functional limitations, exacerbated by his functional illiteracy, which rendered him substantially unable to perform his pre-accident employment and completely unable to engage in any suitable employment post-104 weeks.

The income replacement benefit claim was granted.

The claim for attendant care benefits was dismissed, as the Applicant's family and friends did not suffer an economic loss, and the evidence did not support the need for 24/7 supervision.

Claims for medical treatments and assessments were partially granted based on reasonableness and necessity.

The applicant was injured in a motor vehicle accident and sought a determination of catastrophic impairment based on mental or behavioural disorders (Criterion 8).

The applicant suffered a severe breast injury resulting in chronic pain, which she argued caused marked impairments in social functioning and adaptation.

The arbitrator applied the AMA Guides and found that while the applicant suffered from mental disorders, her impairments in social functioning and adaptation were at most moderate (Class 3).

The arbitrator concluded that the applicant's work challenges stemmed primarily from physical pain rather than a mental disorder, and dismissed the application for catastrophic impairment.