Howard R. Blitstein

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to an income replacement benefit (IRB), an award for unreasonable delay, and interest.

The Tribunal found that the applicant was employed as a machine operator at the time of the accident and that the accident caused pre-existing degenerative changes in his lumbar spine to become symptomatic.

The Tribunal preferred the evidence of the applicant's physiatrist over the respondent's, noting it was based on more comprehensive medical records including an MRI.

The Tribunal concluded the applicant suffered a substantial inability to perform the essential tasks of his employment and awarded IRBs at $384 per week for the first 104 weeks.

However, the applicant failed to prove a complete inability to engage in any suitable employment after 104 weeks.

The claim for a special award was dismissed, but interest on overdue benefits was granted.

The parties settled the appeal and requested the court to allow the appeal and set aside the trial judge's judgment.

The Court of Appeal, noting the public interest in settling litigation and the respondents' concession that there was a basis to allow the appeal, approved the order sought.

The appeal was allowed, the trial judgment set aside, and the action dismissed in accordance with the minutes of settlement.

The insurer appealed an arbitrator's decision awarding interest on overdue medical benefits from 14 days after the receipt of the treatment plan.

The insurer argued that, based on previous appeal decisions, interest should only accrue from the date of the arbitrator's order because it had relied on a negative Designated Assessment Centre (DAC) report to deny the benefits.

The Director's Delegate dismissed the appeal, declining to follow the previous appeal decisions.

The Delegate held that the requirement to pay medical benefits does not depend on a positive DAC report or an arbitrator's decision, and that interest is mandatory and compensatory, flowing from a finding that benefits were payable and not paid on receipt of the required application documents.

The applicant was injured in a motor vehicle accident and applied for statutory accident benefits.

The insurer denied a treatment plan for massage therapy based on a negative Designated Assessment Centre (DAC) report.

In a previous arbitration decision, the arbitrator found the treatment plan was reasonable and necessary, and awarded the medical benefit.

The current issue was when interest on the overdue payment started to run.

The insurer argued that based on previous appeal decisions, interest should not run until the date of the arbitration decision because of the negative DAC report.

The arbitrator distinguished the appeal decisions, finding that the DAC report was flawed and the insurer had ample evidence to support the claim.

The arbitrator held that the interest provisions are compensatory and remedial, and that interest started to run 14 days after the treatment plan was submitted to the insurer.

The applicant was injured in a motor vehicle accident and sought payment for two treatment plans for massage therapy to treat chronic pain.

The insurer denied the claims, relying on various medical and DAC reports.

The arbitrator found the applicant's testimony credible that massage therapy provided temporary pain relief, which in turn allowed her to engage in active exercise to improve her strength and endurance.

The arbitrator gave little weight to the insurer's medical reports, noting they either did not address massage therapy or lacked sufficient reasoning.

The arbitrator concluded that the massage therapy was a reasonable and necessary medical benefit under section 14 of the Statutory Accident Benefits Schedule and ordered the insurer to pay the claimed amount of $5,190 plus interest.