2 total
Accident benefits claims dismissed as applicant failed to prove causation due to lack of pre-accident medical records.
The applicant sought statutory accident benefits for rehabilitation and care services following a 1993 motor vehicle accident.
The insurer denied the claims, arguing the applicant's pervasive physical, cognitive, and psychological conditions were not caused by the accident.
The arbitrator dismissed the applicant's claims, finding she failed to prove on a balance of probabilities that the accident materially contributed to her impairments.
The arbitrator noted a complete absence of pre-accident medical records, relying solely on the applicant's unreliable self-reporting, and drew an adverse inference from her failure to call pre-accident treating physicians or lay witnesses to corroborate her pre-accident health and functional abilities.
Arbitrator adjusts RECDAC finding to part-time capacity and upholds insurer's use of LECB rollover provision.
The applicant was injured in three motor vehicle accidents.
She applied for statutory accident benefits.
The insurer relied on section 21(9) of the Schedule to delay making a loss of earning capacity benefit (LECB) offer until two years after the second accident.
A RECDAC assessment concluded she could work full-time as a parking lot attendant.
The arbitrator found the applicant to be an unreliable historian due to her failure to disclose a significant pre-accident history of workplace injuries.
However, based on the medical evidence, the arbitrator found she suffered significant psychological and physical impairments.
The arbitrator concluded the RECDAC overestimated her functional abilities, finding she could only work part-time as a parking lot attendant.
Claims for acupuncture and a special award for delay were dismissed.
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