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Insured entitled to ongoing income replacement benefits after unsuccessful attempts to return to work.
The applicant was injured in a motor vehicle accident and received statutory accident benefits.
The insurer terminated her income replacement benefits, arguing she was capable of returning to work.
The arbitrator found that the applicant made honest and sustained attempts to return to her pre-accident employment as an accountant, but was unable to continue due to her injuries.
The arbitrator rejected the insurer's medical assessments suggesting a lack of motivation, finding the applicant's testimony credible and her attempts to work genuine.
The applicant was found to be substantially disabled from performing the essential tasks of her employment and completely unable to engage in suitable employment, entitling her to ongoing income replacement benefits.
Income replacement benefits reinstated; applicant's accident-related depression caused substantial inability to perform stressful nursing duties.
The applicant, a visiting mental health nurse, was injured in a motor vehicle accident and received income replacement benefits.
She attempted a graduated return-to-work program coordinated by the insurer, but struggled with physical pain and psychological difficulties.
The insurer terminated her benefits based on assessments indicating she was no longer physically disabled.
The arbitrator found that while the applicant was physically capable of performing most tasks, the demanding and stressful nature of her job, which involved treating acutely psychotic patients alone in the community, meant she was substantially disabled by her accident-related depression.
The arbitrator awarded ongoing income replacement benefits, certain medical and rehabilitation expenses, but denied the applicant's claim for a special award and the insurer's claim for repayment of benefits.
Insurer ordered to pay ongoing income replacement benefits where accident materially contributed to disability despite pre-existing conditions.
The applicant was injured in a motor vehicle accident and received weekly income replacement benefits until the insurer terminated them, arguing she was no longer disabled.
The applicant, who had significant pre-existing conditions including rheumatoid arthritis and degenerative disc disease, claimed the accident materially contributed to her ongoing inability to perform her essential tasks as a building superintendent.
The arbitrator rejected the insurer's medical examinations, finding them flawed and incomplete, and preferred the evidence of the applicant's treating physicians.
The arbitrator concluded the accident significantly contributed to her disability and ordered the insurer to pay ongoing weekly income replacement benefits, interest, and expenses.
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