Mr. Egarhos

The applicant was injured in a bicycle accident and received income replacement benefits (IRBs) for 104 weeks.

The insurer terminated the benefits at the 104-week mark based on multidisciplinary assessments concluding she did not suffer a complete inability to engage in employment for which she was reasonably suited.

The applicant sought ongoing IRBs, arguing she could only work part-time.

The Tribunal dismissed the application, finding the applicant failed to provide compelling medical evidence to rebut the insurer's seven assessments.

The Tribunal noted the applicant's successful transition to part-time work as a baker and yoga instructor demonstrated an ability to engage in suitable employment.

The applicant sought reconsideration of a Tribunal decision denying medical benefits and post-104 week income replacement benefits.

The applicant introduced fresh evidence in the form of a psychiatric assessment by the respondent's own expert, which causally linked the applicant's severe alcohol use disorder and depression to the accident.

The Tribunal admitted the fresh evidence and found that the applicant sustained psychological impairments as a result of the accident.

Consequently, the Tribunal concluded the applicant suffered a complete inability to perform any occupation and awarded post-104 week income replacement benefits, as well as medical benefits for a psychological assessment and occupational therapy.

The request for personal training services was dismissed.

The applicant sought dispute resolution at the Licence Appeal Tribunal after being denied post-104 week income replacement benefits, medical benefits, and costs of examinations following a motor vehicle accident.

The adjudicator found that while the applicant suffered physical impairments from the accident, he did not suffer a complete inability to engage in any employment for which he was reasonably suited.

The adjudicator preferred the respondent's vocational evidence, finding the applicant could work as a delivery driver.

The adjudicator also found the applicant's psychological issues were caused by subsequent life stressors, not the accident.

The claims for medical benefits and assessments were dismissed as not reasonable or necessary.