Dr. S. Garner

The applicant, a registered nurse, was struck by a school bus and claimed catastrophic impairment due to physical, cognitive, and psychological injuries.

The insurer disputed the catastrophic designation and denied ongoing attendant care and housekeeping benefits.

The arbitrator found the applicant sustained a catastrophic impairment under both the marked mental/behavioural impairment threshold and the 55% whole person impairment threshold, preferring the evidence of the applicant's experts who properly accounted for her severe depression and chronic pain.

The arbitrator awarded ongoing attendant care, housekeeping benefits, the cost of a cellphone, and a special award due to the insurer's unreasonable delay in reinstating income replacement benefits.

The applicant, a self-employed taxi driver, was injured in a rear-end motor vehicle accident and claimed statutory accident benefits.

The insurer paid income replacement benefits for the first 104 weeks but denied post-104 week benefits, arguing the applicant was not completely unable to engage in suitable employment.

The arbitrator found that the applicant's physical impairments, including neurologically-based low back pain, combined with cognitive and emotional difficulties, rendered him completely unable to work full-time in any suitable occupation.

The arbitrator ordered the insurer to pay post-104 week income replacement benefits, to be recalculated without improperly deducting capital cost allowance.

Furthermore, the arbitrator awarded a special award under section 282(10) of the Insurance Act, finding that the insurer unreasonably withheld benefits by failing to critically analyze the medical and accounting evidence and misapplying the legal test for complete inability.

The applicant was injured in a motor vehicle accident and claimed income replacement benefits (IRBs).

The insurer denied IRBs on the basis that the applicant continued to receive her full salary from her employer, a closely-held corporation in which she and her husband were majority shareholders.

The arbitrator found that the payments made while the applicant was completely unable to work were a loan, not employment income, and therefore not deductible from IRBs.

However, the full salary paid during periods when she returned to work part-time was deductible as post-accident employment income, as her work was commercially productive.

The arbitrator also determined that the applicant was substantially disabled for specific periods, but not continuously, relying on independent medical and functional assessments over her subjective reports of pain.