Dr. Michael E. Kliman

The applicants, who were injured in a rear-end motor vehicle collision, sought arbitration after the insurer terminated their statutory accident benefits.

Mr. Narain claimed ongoing income replacement benefits, medical benefits, housekeeping expenses, and the cost of a medical assessment.

Ms. Mangroo claimed income replacement benefits, medical benefits, and housekeeping expenses.

The arbitrator found Mr. Narain credible regarding his ongoing back and knee pain, granting his claim for income replacement benefits and the cost of a physiatrist's report, but dismissed his claims for further medical treatment and housekeeping expenses.

Conversely, the arbitrator found Ms. Mangroo to be an unreliable witness due to numerous inconsistencies in her evidence and dismissed all of her claims, concluding she failed to prove a substantial inability to perform her pre-accident employment or housekeeping tasks.

The appellant, a pedestrian struck by a vehicle, appealed an arbitrator's decision dismissing his claim for weekly income benefits.

The appellant had returned to work for several years before being laid off due to lack of work.

The Director's Delegate upheld the arbitrator's finding that the appellant failed to prove his injuries continuously prevented him from engaging in suitable employment, as required by section 12(5)(b) of the SABS-1990, and failed to rebut the presumption of ineligibility under section 16(2) arising from his extended return to work.

The appeal was dismissed.

The applicant, a self-employed taxi driver, sought income replacement benefits following a motor vehicle accident.

The insurer denied the claim on the basis that the applicant failed to provide sufficient financial and medical information to determine entitlement.

The arbitrator found that the applicant failed to comply with his obligations under section 33 of the Statutory Accident Benefits Schedule by providing inadequate financial records and refusing to authorize the release of clinical notes from his treating physicians.

Consequently, the applicant was disentitled to benefits.

The arbitrator also found that the applicant failed to prove a substantial inability to perform the essential tasks of his employment.

The claim for a special award was dismissed.

The applicant was injured while a passenger on a bus and received statutory accident benefits.

The insurer terminated weekly income benefits and supplementary medical benefits in 1995.

The applicant sought reinstatement of weekly income benefits, and the insurer sought repayment of medical benefits paid for psychological treatment.

The arbitrator found that the applicant was physically and psychologically capable of returning to work by April 1995, dismissing the claim for ongoing weekly income benefits.

The arbitrator also dismissed the insurer's claim for repayment, finding the psychological treatment received prior to termination was reasonable and beneficial.