Dr. M. Weber

The applicant was injured in a motor vehicle accident and received income replacement benefits (IRBs) until the insurer terminated them, alleging failure to cooperate with a Residual Earning Capacity Designated Assessment Centre (REC DAC).

The applicant applied for arbitration, seeking ongoing IRBs and attendant care benefits.

The arbitrator found that the REC DAC did not report a failure to cooperate, meaning the insurer improperly stopped the IRBs.

On the merits, the arbitrator preferred the evidence of the applicant's medical experts, finding that the applicant suffered from a psychotic disorder and post-concussion syndrome caused by the accident, rendering him substantially unable to perform his pre-accident employment.

The insurer's allegations of malingering were rejected.

However, the claim for attendant care benefits was dismissed due to insufficient evidence of need, particularly given surveillance showing the applicant driving and taking public transit independently.

The applicant, a 52-year-old bricklayer with limited English skills, was injured in a motor vehicle accident.

He applied for statutory accident benefits, claiming ongoing weekly income benefits beyond the 156-week mark, care benefits, and a special award.

The insurer argued he was capable of performing alternative sedentary work.

The arbitrator found that the applicant suffered from a combination of musculoskeletal injuries, mild brain injury, and psychological impairments that rendered him competitively unemployable.

The arbitrator awarded ongoing weekly income benefits and care benefits for the assistance provided by his family, but denied the claim for a special award.

The applicant was injured in a motor vehicle accident and received weekly income benefits for 156 weeks.

The insurer terminated benefits at the 156-week mark, asserting the applicant no longer met the more onerous disability test of being continuously prevented from engaging in any reasonably suitable employment.

The applicant sought ongoing benefits and a special award.

The arbitrator found that while the applicant required a brief adjustment period to return to work, she did not suffer a continuous disability preventing her from engaging in suitable employment beyond June 1, 1994.

The arbitrator preferred the insurer's medical evidence, noting inconsistencies in the applicant's presentation and surveillance footage showing her performing physical tasks without apparent difficulty.

The claim for ongoing benefits after June 1, 1994, and the request for a special award were dismissed.

The applicant was injured in a motor vehicle accident and received statutory accident benefits until the insurer terminated them.

She applied for ongoing weekly income benefits, arguing she suffered from post-concussion syndrome and a brain injury that prevented her from working.

The insurer argued her inability to work was due to pre-existing psychological conditions and post-accident life events.

The arbitrator found that the accident materially contributed to her disability, exacerbating a pre-existing personality disorder, and that she was continuously prevented from engaging in suitable employment.

The arbitrator also ordered a $5,000 special award against the insurer for unreasonably terminating and withholding benefits based on a cursory neurological report while ignoring numerous other medical recommendations.