Dr. S.W. Bartol

The applicant was injured in a motor vehicle accident and sought post-104 income replacement benefits (IRBs) and the cost of an attendant care assessment.

The respondent denied the benefits and sought to exclude late-served s. 44 catastrophic impairment reports.

The Tribunal admitted the reports, finding no prejudice to the respondent.

On the merits, the Tribunal found the accident was a necessary cause of the applicant's back pain and surgeries.

Relying on both the applicant's and the respondent's medical experts, the Tribunal concluded the applicant suffered significant psychological impairments, including a marked to extreme impairment in adaptation to work settings, rendering her completely unable to engage in suitable employment.

The Tribunal awarded the post-104 IRBs but denied the attendant care assessment cost due to insufficient evidence.

The applicant, who was 12 years old at the time of the motor vehicle accident, sought statutory accident benefits for physical and psychological impairments.

The respondent insurer denied the benefits, arguing the injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant failed to provide sufficient objective medical evidence to establish that he sustained physical or psychological impairments outside the MIG.

Furthermore, the applicant did not prove that his pre-existing cognitive and psychological conditions prevented him from achieving maximal recovery within the MIG limits.

Consequently, the disputed treatment plans for physiotherapy and psychological services were deemed not reasonable and necessary, and no interest was payable.

The appellant was injured in a motor vehicle accident and claimed income replacement benefits.

The insurer terminated benefits based on medical assessments indicating the appellant could return to work.

The arbitrator dismissed the appellant's claim for ongoing benefits, finding he was not substantially unable to perform the essential tasks of his self-employment in construction, and calculated a reduced benefit rate based on estimated business expenses.

On appeal, the Director's Delegate upheld the arbitrator's decision, finding no error in the assessment of the expert medical evidence or the pragmatic calculation of the appellant's self-employment income.

The applicant was injured in a minor rear-end motor vehicle accident and subsequently developed chronic pain and fibromyalgia.

The insurer terminated his weekly income replacement benefits after a DAC assessment concluded he could return to work.

The arbitrator found that the applicant sustained an impairment in his lower back arising from the accident, which caused a substantial inability to perform the essential tasks of his employment as an assembly line worker.

The arbitrator also found that the applicant suffered from post-traumatic fibromyalgia.

The applicant was awarded ongoing income replacement benefits, costs for a physical fitness programme, expenses for attending a Fibromyalgia Outpatient Programme, partial housekeeping expenses, interest, and arbitration expenses.

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

The insurer terminated benefits, arguing the applicant's ongoing disability was due to pre-existing degenerative changes and that he was not continuously prevented from engaging in suitable alternative employment.

The arbitrator preferred the medical evidence attributing the applicant's chronic pain to the accident.

The arbitrator also accepted vocational evidence that the applicant lacked the education, training, and skills for the alternative jobs proposed by the insurer, and found the applicant was entitled to ongoing weekly income benefits.

The applicant, a 62-year-old labourer with a grade three education, was struck by a motor vehicle and suffered multiple injuries, including fractured ribs and a head injury.

He applied for ongoing weekly income benefits under section 12(5)(b) of the Statutory Accident Benefits Schedule after the insurer terminated them.

The arbitrator found that the applicant suffered from post-concussion syndrome and chronic disabling pain resulting from the accident.

Given his age, limited education, poor English skills, and physical limitations, the arbitrator concluded that the applicant was continuously prevented from engaging in any suitable occupation or employment.

The insurer was ordered to pay weekly income benefits of $536.75 from May 5, 1994 onwards, plus interest and expenses.

The applicant was injured in a motor vehicle accident when she was struck by a car as a pedestrian, sustaining knee injuries.

The insurer terminated her weekly income benefits after approximately 20 months.

The applicant sought ongoing benefits, arguing she was substantially unable to perform the essential tasks of her pre-accident employment as a fast-food restaurant assistant manager.

The arbitrator found that while the applicant had some limitations with heavy lifting and repetitive crouching, she could perform the great majority of her essential tasks without difficulty.

The application for ongoing weekly income benefits and a special award was dismissed, though the applicant was awarded her arbitration expenses.