Mr. L. Grimaldi

The applicant sought statutory accident benefits following a motor vehicle accident, including an income replacement benefit (IRB) and various medical benefits.

The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and she did not suffer a substantial inability to perform the essential tasks of her self-employment.

The Tribunal found the applicant failed to prove entitlement to an IRB, preferring the respondent's assessors who personally evaluated her over the applicant's paper-review assessor.

The Tribunal also concluded the applicant's physical, dental (TMJ), and psychological injuries did not warrant removal from the MIG.

The application was dismissed.

The applicant was injured in a motor vehicle accident and received statutory accident benefits, including income replacement benefits (IRBs), which the insurer terminated after approximately 21 months.

The applicant sought ongoing IRBs under both the pre-104 week 'own occupation' test and the post-104 week 'any occupation' test.

The arbitrator found that the applicant sustained significant orthopaedic injuries, particularly to his right hip and left hand, which prevented him from performing the heavy physical demands of his pre-accident employment as a welder.

Furthermore, given the applicant's limited English proficiency and lack of transferable skills, the arbitrator concluded he suffered a complete inability to engage in any employment for which he was reasonably suited by education, training, or experience.

The applicant was awarded ongoing IRBs and interest, but his claim for a special award was dismissed as the insurer's reliance on its medical assessments was not unreasonable.