Marvin Shedletzky

The applicant sought interim income replacement benefits after the insurer terminated them.

The arbitrator found that the insurer's termination of benefits was based on a flawed Designated Assessment Centre (DAC) process, which failed to comply with section 64 of the Statutory Accident Benefits Schedule.

The arbitrator also found that the applicant established a strong prima facie case for entitlement to benefits and demonstrated financial urgency.

The insurer was ordered to pay interim benefits of $313.77 per week, with the issues of a special award and expenses reserved for the main arbitration hearing.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including medical/rehabilitation benefits and income replacement benefits.

The insurer terminated treatment payments and income replacement benefits based on medical assessments.

At arbitration, the tribunal ordered the insurer to pay for physiotherapy treatment up to the date the applicant received the Designated Assessment Centre (DAC) reports, at the rates charged by the clinic.

However, the tribunal dismissed the claim for ongoing income replacement benefits, finding that the medical evidence, including psychiatric and orthopaedic assessments, did not establish a substantial inability to perform the essential tasks of her pre-accident employment as a sewing machine operator.