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Income replacement benefits denied for pre-existing back injury, but procedural continuation of benefits granted pending DAC assessment.
The applicant was injured in a motor vehicle accident and received income replacement benefits until the insurer terminated them based on an orthopaedic assessment.
The applicant sought continued benefits under section 7 of the Statutory Accident Benefits Schedule, claiming a lower back injury prevented him from working.
The arbitrator found that the applicant's lower back problems were a recurrence of a pre-existing condition and not caused by the accident, dismissing the section 7 claim.
However, the arbitrator found that the insurer was required to pay benefits under section 64 of the Schedule from the date the applicant provided a signed medical release form until the date he was notified of the negative Designated Assessment Centre report.
