Vida Sernas

The applicant was injured in a rear-end motor vehicle accident and sought ongoing income replacement benefits, which the insurer terminated.

The arbitrator found that the applicant was substantially unable to perform the essential tasks of his employment due to accident-related low back pain, which was compounded by a pre-existing knee condition and psychological factors.

The arbitrator also held that the insurer failed to comply with the mandatory termination notice procedures under section 64 of the Statutory Accident Benefits Schedule, depriving the applicant of the opportunity to request a DAC assessment.

As a result of the insurer's non-compliance and unreasonable withholding of benefits, the applicant was awarded ongoing income replacement benefits and a $5,000 special award.