Geoffrey Adair

The appellant was injured in a motor vehicle accident and received weekly income benefits.

The insurer terminated benefits after 156 weeks, arguing that the appellant's ongoing neuropathic leg pain was not caused by the accident.

An arbitrator dismissed the appellant's claim for ongoing benefits, preferring the medical evidence that a causal link was unlikely given the delayed onset of symptoms.

On appeal, the Director's Delegate upheld the arbitrator's decision, finding no error in the assessment of the expert medical evidence regarding causation.

The appeal was dismissed and no appeal expenses were awarded.

The applicant was injured in a motor vehicle accident in January 1991 and received statutory accident benefits until January 1995.

He subsequently developed severe neuropathic pain in his left leg and sought ongoing weekly income benefits and medical benefits.

The insurer disputed that the neuropathic condition was caused by the accident.

The arbitrator reviewed extensive medical evidence and testimony, noting a significant time lag between the accident and the onset of the leg pain.

The arbitrator concluded that the applicant failed to prove on a balance of probabilities that the accident caused the neuropathic condition.

Consequently, the claims for ongoing benefits were dismissed.

The insurer's claim for repayment was also dismissed, and the applicant was awarded his arbitration expenses.

The applicant was injured in an accident and applied for workers' compensation benefits, which were denied by the Workers' Compensation Board (WCB) on the basis that he was not in the course of his employment.

He then applied for statutory accident benefits from the insurer.

The insurer argued that the applicant's WCB claim was made in bad faith and that he was actually in the course of his employment, meaning he should be receiving WCB benefits instead of accident benefits.

On a preliminary motion, the arbitrator held that the Commission has no jurisdiction to go behind the WCB's decision regarding entitlement to workers' compensation benefits, as the WCB has exclusive jurisdiction over that issue.

The applicant applied for caregiver benefits under the Statutory Accident Benefits Schedule, claiming he quit his job to provide full-time care for his son who was injured in a motor vehicle accident.

The insurer had paid some benefits but later sought repayment, arguing the payments were made in error.

The arbitrator found that the son's injuries did not require full-time care beyond normal parental duties and that the applicant had quit his jobs for economic reasons, not to provide care.

The arbitrator dismissed the claim for additional benefits and ordered the applicant to repay $36,295.00 to the insurer, finding that the applicant had misled the insurer about his employment and caregiving status.