Neutral Citation: 1996 ONICDRG 64
ONTARIO INSURANCE COMMISSION
BETWEEN:
Sadeah Movahedi
Applicant
and
State Farm Mutual Automobile Insurance Company
Insurer
DECISION
Issues:
The Applicant, Sadegh Movahedi, was injured in a motor vehicle accident on February 26, 1993. He applied for and received statutory accident benefits from the Insurer State Farm Mutual Automobile Insurance Company ("State Farm"), payable under Ontario Regulation 672, the Statutory Accident Benefits Schedule — Accidents before January 1, 1994, (the Schedule").1 Mr. Movahedi received weekly income benefits at the rate of $540.00 from March 5, 1993 until September 3, 1993 when they were terminated.
The parties were unable to resolve their disputes through mediation and Mr. Movahedi applied for arbitration under the Insurance Act, R.S.O. 1990, c.I.8, as amended.
The issues in this hearing are:
Is Mr. Movahedi entitled to weekly income benefits after September 3, 1993 under section 12(1) of the Schedule?
What is the correct amount of Mr. Movahedi's weekly income benefits?
Has State Farm overpaid Mr. Movahedi any weekly income benefits? If so, is State Farm entitled to a repayment?
Is Mr. Movahedi entitled to further supplementary medical and rehabilitation benefits under section 6(1) of the Schedule?
Is Mr. Movahedi entitled to a special ward under section 282(10) of the Insurance Act?
Mr. Movahedi also claims interest on any amounts owing, and his expenses incurred in the hearing.
Result:
State Farm is not required to pay Mr. Movahedi further weekly income benefits.
The correct amount of Mr. Movahedi's weekly income benefits is $540.00.
State Farm has not overpaid weekly income benefits. It is not entitled to a repayment.
I make no orders or findings of fact in respect of Mr. Movahedi's entitlement to further supplementary medical and rehabilitation benefits.
Mr. Movahedi is not entitled to a special award.
State Farm shall pay Mr. Movahedi's expenses in respect of the arbitration proceedings.
Hearing:
The hearing was held in Toronto, Ontario, on June 26, 27, August 22 and 23, 1995, before me, Asfaw Seife, Arbitrator. The filing and exchange of written submissions was completed on September 28, 1995.
Present at the Hearing:
Applicant:
Sadegh Movahedi
Applicant's Counsel:
Michael Henry Barrister and Solicitor
Insurer's Counsel:
Jim Flaherty Barrister and Solicitor
Joan Chadwick Barrister and Solicitor
Insurer's Representative:
Scott Knight
Exhibits:
Listed in Appendix "A" to this decision.
Witnesses:
Sadeghi Movahedi The Applicant
Dr. Mojgan Zare-Parsi Psychiatrist
Dr. James Houston Orthopaedic Surgeon
The proceedings were recorded by court reporters of Quest Court Reporting Services. Ms. Jalleh Kermanshahi provided interpretation in the Farsi language.
Background:
At the time of the accident on February 26, 1993, Mr. Movahedi was a single, 29 year old, self-employed taxi driver. The accident occurred in Toronto when the taxi Mr. Movahedi was driving was struck by an automobile which had gone through an intersection against a red light. Mr. Movahedi testified that at the time of impact, his head hit the ceiling of the car, and his left side struck the seat of the car. He experienced severe pain in his neck and lower back while still at the scene of the accident; however, he did not lose consciousness.
After the accident, Mr. Movahedi was taken by ambulance to St. Michael's hospital where he was examined and x-rayed. Mr. Movahedi was released from hospital the same day with a prescription for Tylenol #2; however, two days later, he returned to the hospital with complaints of increasing back pain, radiating to his left leg. The pain from the neck also radiated to his shoulders and legs. He had cramps in his left leg.
In the months following the accident, in addition to being treated with pain medication by his family physician Dr. M. Boozary, Mr. Movahedi has been seen by several medical practitioners and has received various treatments. He has undergone various investigative procedures, including x-rays, a bone scan, CT-Scan of the spine and E.M.G.
Before the termination of his weekly income benefits on September 3, 1993, Mr. Movahedi was treated by Dr. Chow, a specialist in physical and rehabilitation medicine; and Dr. F. Shahidi, a chiropractor. He was assessed by Dr. James Houston, an orthopaedic surgeon, at the request of State Farm. Since September 3, 1993, Mr. Movahedi was seen by numerous health care practitioners, upon referral by Dr. Boozary, including Dr. Zare-Parsi, psychiatrist; Dr. Bernard Schacter, neurosurgeon; Dr. Ezra Silverstein, orthopaedic specialist; Dr. A. Kachooie, a physiatrist; Dr. Mahmood Fazl, a neurosurgeon; and Dr. Peter Bastian, a specialist in temporomandibular joint (TMJ) disorders. Mr. Movahedi was assessed by Dr. Hugh Cameron, orthopaedic surgeon, at the request of State Farm.
The medical reports and clinical notes and records of the health care practitioners who have treated or assessed Mr. Movahedi were filed in evidence. In addition, Dr. Zare-Parsi and Dr. James Houston testified at the hearing.
Despite the treatments and medications he has received since the accident, Mr. Movahedi claims that his physical symptoms and psychological complaints have shown no improvement, in fact, they have worsened. As a result, he has not been able to return to his pre-accident employment as a taxi-driver or to any other employment. He has not attempted to engage in any kind of work since the accident.
Essential Tasks:
Mr. Movahedi testified about his essential tasks as a taxi driver. He stated that he worked up to 18 hours a day, seven days a week. He spent most of this time sitting behind the wheels, driving the taxi or waiting for passengers. Occasionally, he got out of the taxi to open the taxi door for passengers or to help them with their luggage.
Based on Mr. Movahedi's testimony, I find that the physical demands of driving a taxi include prolonged sitting while operating the taxi or waiting for passengers, occasional light lifting of parcels and luggage, light pulling and pushing, and occasional short distance walking. I find that operating a taxi also requires mental alertness, including paying attention to the traffic, talking to passengers, communicating with dispatching personnel, performing financial transactions and completing required documentation.
Entitlement to Weekly Income Benefits:
In order to be entitled to weekly income benefits after September 3, 1993, Mr. Movahedi must prove, on a balance of probabilities, that because of injuries resulting from the motor vehicle accident of February 26, 1993, he suffers a substantial inability to perform the essential tasks of his employment or occupation.
Mr. Movahedi testified that he is unable to perform his essential tasks as a taxi driver because he cannot concentrate; he cannot stand or sit for periods longer than twenty minutes, or carry things; he has difficulty getting in and out of a car and he cannot turn his head to look around while driving. During driving his leg muscle cramps and his feet are always cold. He has continuing jaw pain, but this does not interfere with his functional abilities.
State Farm contends that the physical injuries Mr. Movahedi sustained in the accident did not result in a substantial inability to perform his essential tasks after the termination of his weekly income benefits. State Farm submits Mr. Movahedi's psychological problems are not caused by the car accident, rather they are the result of numerous events in his life, both before and after the accident, unrelated to the car accident in question.
Physical Problems:
Mr. Movahedi testified that his current physical problems consist of: headaches, which he gets five or six times a week for about half an hour at a time; temporomandibular (TMJ) pain; a "creeping sleeping" pain in the shoulders; constant, severe low back pain which gets worse when he walks, bends, or stays in one position for "more than 10 or 20 minutes"; leg pain, the right one being worse than the left, which he gets when he sits for a while, bends or moves his knees; and neck pain upon turning his head or moving it up and down. Mr. Movahedi claims that his complaints of pain are physiologically based.
X-rays of Mr. Movahedi's lumbar spine taken on the day of the accident show no abnormalities; however, the report of the CT-Scan of his spine taken on August 31, 1993 noted "a congenitally narrowing spinal canal at all levels" which is "somewhat more pronounced at the L4-5 level."
Counsel for Mr. Movahedi contends that this is evidence of an objective, physiological basis for Mr. Movahedi's complaints of low back pain. Counsel submits that this condition is caused by the accident since "there is no suggestion in the evidence that Mr. Movahedi had this stenosis before the accident, or that Mr. Movahedi was symptomatic before the accident as regards to his back."
Several doctors who have examined Mr. Movahedi since the accident have commented on the relationship between Mr. Movahedi's spinal stenosis and his complaints of low back pain. The preponderance of the medical opinion indicates that Mr. Movahedi's spinal stenosis likely pre-existed the accident; however, there is little agreement amongst the doctors that Mr. Movahedi's complaints of back pain arise from his spinal stenosis. Even if the stenosis is the source of Mr. Movahedi's pain, the medical evidence is not sufficient to warrant the conclusion that this was due to his spinal stenosis becoming symptomatic as a result of the accident.
Dr. Boozary, Mr. Movahedi's family doctor, felt that Mr. Movahedi's "neuro-myofacial back pain" was due to "a congenital spinal canal narrowing which became symptomatic as a result of the accident." The physiatrists, Dr. Kachooie and Dr. Chow, agreed that Mr. Movahedi's back pain referring to his lower extremity is compatible with spinal stenosis. However, unlike Dr. Kachooie, Dr. Chow was not prepared to go as far as stating that the spinal stenosis became symptomatic as a result of the car accident.
Dr. Mahmood Fazl, the neurologist at the Sunnybrook Health Sciences Centre whom Dr. Boozary consulted, stated in his report that while the CT scan suggests some stenosis at L4-5 level, he felt he could not "even make a diagnosis of lumbar spinal stenosis because the dural sac is not compressed at L4-5."
Dr. LB. Schacter, Mr. Movahedi's neurologist, like Dr. Boozary and Dr. Kachooie, felt that Mr. Movahedi's complaints in his lower extremities are explained by the stenosis; however, he was unsure about the causal link between the stenosis and the car accident. Dr. Schacter suggested that if Mr. Movahedi did not have symptoms prior to the accident, the trauma of the car accident would be responsible for his injury.
In his testimony, Mr. Movahedi denied any back or neck problems before the accident. However, the emergency records at St. Michael's Hospital on the day of the accident indicate that Mr. Movahedi told the treating doctor that he had prior back pain which became worse after the accident. Mr. Movahedi denied telling this to the doctor. In his clinical notes of April 22, 1992, Dr. Boozary indicates that Mr. Movahedi reported neck and back pain. Mr. Movahedi testified he could not recall the incident.
I accept the information in medical records created by health professionals in the normal course of discharging their duties. While this evidence is not sufficient to establish that Mr. Movahedi's pain was caused by a pre-existing stenosis, I find that it warrants the conclusion that Mr. Movahedi did suffer from back and neck pain prior to the accident.
Dr. Silverstein, Mr. Movahedi's orthopaedic surgeon, did not find Mr. Movahedi's spinal stenosis had any clinical relevance to his condition. Dr. Silverstein suggested that Mr. Movahedi's problems were psychological in nature. This opinion was consistent with that of Dr. Houston, the orthopaedic specialist who assessed Mr. Movahedi at the request of State Farm in June, 1993. Dr. Houston was of the view that the spinal stenosis was not responsible for Mr. Movahedi's complaints.
In January 11, 1995, Mr. Movahedi was examined by another orthopaedic specialist Dr. Hugh Cameron who concluded that Mr. Movahedi's symptoms "are not really that of spinal stenosis." Dr. Cameron commented that Mr. Movahedi had a physiological condition that exists with "a large percentage of the population" without causing symptoms.
Having considered the totality of the medical evidence, I am not persuaded that Mr. Movahedi's continued complaints of pain are explained by objective, physiological findings.
Psychological Problems:
Mr. Movahedi testified that mentally, he suffers from depression which "comes and goes." He stays at home most of the time because he does not want to see anybody. He is sleepless. He has memory problems, and cannot concentrate. For example, he cannot follow what he is watching on television.
Mr. Movahedi alleges that because of his psychological condition, he has encountered several problems after the accident which have contributed to his disability.
Mr. Movahedi testified that between May 1993 and the end of 1994, several incidents happened in his life which were stressful to him. During this period, he was involved in a second motor vehicle accident as a passenger; however, he did not sustain any physical injuries. He was drinking heavily, at the same time he was on medication for depression and substance abuse. As a result of his drinking, he lost his driver's licence. He was arrested and charged with impaired driving, robbery and assault. During his arrest he sustained a broken nose, an injury that required surgical treatment. He was having financial problems. He attempted to commit suicide after an argument by taking an overdose of pain killer medication. His girlfriend left him because of his many problems. He was "traumatized" by this event.
Mr. Movahedi denied suffering from depression or any other form of emotional problems before the accident. He was adamant that all of these events, including his heavy drinking and the difficulties in his relationship with his girlfriend, his suicide attempt were caused by the car accident. He stated that it was his "cognitive and financial problems" resulting from the accident that caused him to abuse alcohol, which in turn led to his troubles with the law and his social life.
Mr. Movahedi admitted that he drank before the accident, but denied any problem-drinking until after the accident. In cross-examination, counsel for State Farm referred to Mr. Movahedi's visit to a urologist in April, 1992 in which Mr. Movahedi discussed his drinking habits. Mr. Movahedi denied having a drinking problem at that time; and stated that he told the doctor he had stopped drinking. However, the report from the doctor states that Mr. Movahedi reported he "has slowed down his drinking." Mr. Movahedi was unable to explain this discrepancy. In my view, Mr. Movahedi's problem with drinking started prior to the accident.
Mr. Movahedi was seen by Dr. Zare-Parsi, a psychiatrist, upon referral by Dr. Boozary on October 3, 1993. In her report dated April 5, 1994, Dr. Zare-Parsi stated that Mr. Movahedi reported that he continued to experience severe pain in his neck and back area, as a result of the accident. He also complained of impaired memory and inability to concentrate since the accident, and "lack of motivation for work due to increased pain in his back and limbs." He complained of being depressed and crying very often. He complained of insomnia, and having frequent nightmares of falling down or car accidents. Memories of the car accident still bothered him very frequently. He could not tolerate loud noises, especially noises of cars. He told her he felt very anxious whenever he sat in a car and could not drive a car himself due to his fear of having an accident. Mr. Movahedi also told Dr. Zare-Parsi that he drank "three to five beers a day" to help him cope with his pain.
Mr. Movahedi told Dr. Zare-Parsi that his psychological symptoms started a few months after the car accident of February, 1993. In his testimony, he stated that it was within six weeks of the accident that he began to experience these symptoms. However, I find it significant that there are no notations in the clinical notes and records of the doctors Mr. Movahedi has seen prior to Dr. Zare-Parsi regarding such complaints. I find Mr. Movahedi's complaints of psychological problems began to emerge after the termination of his weekly income benefits.
In her report, Dr. Zare-Parsi concluded that Mr. Movahedi was suffering from major depression and some symptoms of post-traumatic stress disorder." She stated:
[Mr. Movahedi] has ongoing problems with his physical limitations and his chronic pain syndrome. He has no support in place. He finds himself very lonely. His friends are mostly out of town and they drop in very occasionally. His wife [sic] has left him and she is in another city since the separation. Mr. Movahedi still continues to have financial difficulties since he cannot work anymore and he is in debt. All of these are perpetuating factors that are keeping him from recovering. He continues to have depressed mood, difficulty concentrating and impaired memory. His motivation is low to the level that he does not take care of his hygiene and does not prepare food for himself. He seldom goes shopping and very seldom goes out for any socialization.
Dr. Zare-Parsi indicated in her report that "the precipitating factor was the car accident and the disabilities following this accident. The perpetuating stress is his inability to function, his chronic pain, consumption of alcohol, lack of support of friends and family." However, in her testimony under cross-examination, Dr. Zare-Parsi admitted that the causal link between the car accident and Mr. Movahedi's psychological problems was questionable. She did not consider the car accident to be the cause of his psychological problems, but that it was only one factor, among several factors, which affected Mr. Movahedi's psychological health. She admitted that she did not have a good idea of his physical injuries and that she did not have an accurate history of Mr. Movahedi past medical history.
Dr. Zare-Parsi testified that Mr. Movahedi often did not comply with medication prescribed for alcohol abuse. Dr. Zare-Parsi testified that alcohol is a depressant. Mr. Movahedi denied this, saying that he felt better after drinking.
Dr. Zare-Parsi testified that she did not consider that Mr. Movahedi suffered from post traumatic stress disorder. In her view, he only had some elements of the disorder. She considered that the car accident was only one of many stressors in his life causing his psychological problems.
In view of the above evidence, I do not find that Mr. Movahedi's psychological or mental problems were the result of the motor vehicle accident in question.
Credibility and Conclusion:
As a result of the accident, Mr. Movahedi has sustained soft tissue injuries to his back and neck. On the totality of the medical evidence, I am unable to find that his continued complaints of pain have an objective, physical basis. The medical evidence is also insufficient to establish that Mr. Movahedi's psychological and emotional problems were caused by the accident. Therefore, Mr. Movahedi's credibility is crucial in assessing his claims.
I did not find Mr. Movahedi a credible witness. Because of the numerous inconsistencies in his testimony and the documentary and oral evidence, I cannot rely on his testimony to support his subjective complaints of pain and disability.
Mr. Movahedi's denial of any back or neck problems, or problems with his drinking habits, prior to the accident, is contradicted by reliable documentary medical evidence. Although there is no suggestion that at the time of the accident Mr. Movahedi's functional abilities were impaired by his pre-accident problems, I find his adamant denial of any pre-existing problems to be a factor that reflects adversely on his credibility.
Mr. Movahedi alleges constant and severe back pain continuing from the time of the accident without improvement; however, under cross-examination, he admitted that in the months following the accident, his pain had gradually become intermittent. The reports of Dr. Zare-Parsi indicate that by October, 1993, Movahedi was complaining of pain which was "off and on." Dr. Chow noted in his report that Mr. Movahedi reported moderate pain during this time period. During the hearing, State Farm showed a surveillance videotape taken at various times in August, 1993, depicting Mr. Movahedi driving a car, walking at a slow pace, and sitting. In cross-examination, Mr. Movahedi admitted that at that time he walked from his home to a nearby restaurant about half a mile away, and then stopping there for a while and then walking back home. He stated he was able to do this because "he forced himself in order to get better."
Mr. Movahedi admitted that in August, 1993, he was able to drive a car, contrary to what he told Dr. Zare-Parsi in October, 1993. He stated he drove only when he was unable to walk, when he did not have money for taxi, or when he felt better after taking medication. Mr. Movahedi testified that he drove for short distances, on and off, until the end of 1994 when he lost his driver's licence. Mr. Movahedi was questioned by counsel for State Farm if there were any periods of time after the accident when he could not drive a car. He answered that he could drive, but he could not drive "most of the time because of my neck problem" and because of lack of concentration. I heard no evidence about his fear of driving, or his anxiety to sit in a car, as he had reported to Dr. Zare-Parsi. There was also no evidence when Mr. Movahedi drove a car in August of 1993, that he had any neck pain or problem moving his head to look around.
Under cross-examination, Mr. Movahedi admitted that during the early part of this hearing, he remained seated for about one hour and twenty minutes, without standing up or changing his position. Mr. Movahedi explained this by stating that he forced himself to sit because he "was waiting for this session for 28 months."
Dr. Boozary indicates in his report that Mr. Movahedi was disabled from his essential tasks; however, Dr. Boozary's opinion is premised on his understanding that there is an objective, physiological basis to Mr. Movahedi's complaints of pain, and Mr. Movahedi's own reports of his disability. Given my findings above, I do not consider Dr. Boozary's conclusions regarding disability stronger than Mr. Movahedi's testimony.
There is no dispute that Mr. Movahedi suffered soft tissue injuries to lies back and neck as a result of the accident; however, none of the orthopaedic specialist have found any objective, physical basis for Mr. Movahedi's complaints of severe low back, neck, leg, and shoulder pain.
The reports of the orthopaedic surgeons suggest that Mr. Movahedi exaggerated his symptoms on examination. Dr. Silverstein found his symptoms to be "somewhat bizarre" and "his pain responses a lot more dramatic and disabling than [he] could account for on the basis of [his] examination." He felt Mr. Movahedi's problems could be psychological in nature. Dr.Houston and Dr. Cameron have expressed similar views. They saw no reason why Mr. Movahedi could not return to work, from a physical point of view.
It is possible that a person could have pain in the complete absence of any physical findings. However, even if I were to believe Mr. Movahedi's subjective complaints of pain, I am not persuaded by the evidence that the pain is severe enough to render him substantially incapable of performing his essential tasks.
Accordingly, I find that Mr. Movahedi has not proved, on the balance of probabilities, that he is entitled to any further weekly income benefits. In the result, Mr. Movahedi's application for weekly income benefits after September 3, 1993 is dismissed.
Rehabilitation Benefits:
Mr. Movahedi has not identified any dispute with State Farm regarding rehabilitation benefits or expenses. At the outset of the hearing, Mr. Movahedi's counsel was asked to set out his claim for such benefits; however, other than some generalized assertions that Mr. Movahedi needs further rehabilitation, I have received no viva voce or documentary evidence regarding any outstanding rehabilitation expenses.
In his submissions, Mr. Movahedi's counsel stated:
Mr. Movahedi is still not working and he has no idea as to when he will return given the fact that he still has many problems and has not yet been properly rehabilitated. We are also requesting that this Arbitration order Mr. Movahedi to be adequately vocationally rehabilitated; a case manager be appointed for adequate physical/emotional rehabilitation and vocational rehabilitation be put into place funded by the Respondent, outstanding medical be paid and future medical be declared to be paid, including TMJ treatments.
...It is submitted that this Board (sic) can give judicial notice that if a person has multiple emotional and psychological problems, that there must be a multidisciplinary approach to the patient, otherwise his improvement will be nominal, if at all.
I do not agree. In the absence of an identifiable issue that is in dispute, I am not prepared or able to make any order or finding in respect of this claim.
Amount of Weekly Income Benefits:
Weekly income benefits are based on 80 percent of an applicant's gross weekly income from employment or occupation, up to the limits set out under section 12(4) of the Schedule. The gross weekly income is determined in accordance with the rules set out in section 12(7).
Section 12(7) provides that an applicant's gross weekly income from his or her occupation or employment is deemed to be the greatest of:
his or her average gross weekly income for the four weeks preceding the accident; or
his or her average gross weekly income for the 52 weeks preceding the accident; or
$232.00.
In calculating the gross income of applicants who were self-employed at the time of the accident, section 12(7)(3) provides that business expenses which cease as a result of the accident shall be deducted from the person's income from self-employment before calculating the gross weekly income.
Mr. Movahedi has chosen to base the calculation of his gross weekly income on the average for the four weeks preceding the accident.
State Farm paid Mr. Movahedi weekly income benefits at the rate of $540.00 per week. State Farm initially calculated the benefits on the basis of information provided to it by Mr. Movahedi. State Farm now claims that the correct amount of Mr. Movahedi's weekly income benefits is the minimum $185 per week. It submits that Mr. Movahedi has failed to prove the level of earnings upon which his weekly income benefits were based.
Mr. Movahedi testified about his income and expenses for the four weeks preceding the accident. He testified that he worked up to 18 hours a day, seven days a week. He would work until he has cleared at least $100.00 after his expenses. His expenses included $450.00 weekly rental for the taxi, as well as gas and oil expenses. He testified that after expenses he took home between $650.00 and $700.00 every week.
Mr. Movahedi filed documentary evidence in support of his claim, including trip sheets, income tax returns, and bank statements. He also filed an Income and Expenditure Summary report prepared by Johnson Accounting and Tax Services on March 21, 1993, showing the calculation of his benefits. Mr. Movahedi testified that he had submitted the report and all the raw data regarding his expenses to State Farm at the time of his application for benefits.
State Farm has questioned the authenticity of the trip sheets and the bank records; however, it has presented no evidence that would persuade me why the amount of income and expenses as presented in the accounting summary and Mr. Movahedi's oral testimony should not be accepted. I accept the documentary evidence of his earnings as credible and reliable for the purposes of calculating his weekly income benefits.
Based on the evidence before me, I find that in the four weeks preceding the accident, Mr. Movahedi had a gross income of $4,980.00, and his expenses for gas and cab rental for the same period of time amounted to $2,280.00, leaving $2,700.00 as net income after expenses. Based on this, his average weekly income is calculated to be $675.00.($2,700/ 4+ $675.00), giving him a weekly income benefits of $540.00 (80% of $675.00).
Accordingly, I find the correct amount of Mr. Movahedi weekly income benefits is $540.00. I find that Mr. Movahedi was not overpaid, and consequently, it is not necessary for me to deal with the issue of repayment.
Special Award:
Mr. Movahedi claimed a special award under section 282(10) of the Insurance Act ("the Act") on the basis that the Insurer unreasonably withheld benefits. Given my findings above, I find that Mr. Movahedi is not entitled to a special award.
Expenses:
Mr. Movahedi claims his expenses incurred in the arbitration under section 282(11) of the Act which gives an arbitrator the discretion to award an insured person such expenses as prescribed in the regulations, to the maximum set out in the regulations. In this case, I have decided to exercise my discretion in Mr. Movahedi's favour. Although Mr. Movahedi is unsuccessful in the arbitration, I do not find that he commenced the arbitration proceeding in bad faith, or without any merit to his case.
Accordingly, I grant Mr. Movahedi his arbitration expenses. If there is a disagreement about the amount, an assessment may be arranged by contacting the Registrar's Office at the Ontario Insurance Commission.
Order:
State Farm is not required to pay Mr. Movahedi further weekly income benefits.
The correct amount of Mr. Movahedi's weekly income benefits is $540.00.
State Farm has not overpaid weekly income benefits. It is not entitled to a repayment.
I make no orders or findings of fact in respect of Mr. Movahedi's entitlement to supplementary medical and rehabilitation benefits.
Mr. Movahedi is not entitled to a special award.
State Farm shall pay Mr. Movahedi's expenses in respect of the arbitration proceedings.
April 29. 1996
Asfaw Seife Arbitrator
Date
Appendix "A"
Exhibits:
Motor Vehicle Accident Report
Application for Accident Benefits
Statement of Income and Expenses
Taxi Cab Operating Licence
Official Receipt Report - Prescription Drugs
OHIP records from November 1991 to May 1994
Financial Documents, including Income Tax Returns, GST Returns, Accounting Statements, Run Sheets
Income Tax and GST Returns for 1991
Income Tax Returns for 1993 and Accounting Statements
Income and Deductions - Revenue Canada
Bank Records for 1992 and 1993
Surveillance Videotape
Letter dated April 23, 1992 from Dr. Shaul to Dr. L. Cheong
Handwritten Clinical Notes of Dr. Zare-Parsi
St. Michael Hospital Records
Dr. Boozary's Reports, Clinical Notes and Records
Dr. Boozary's Reports, Clinical Notes and Records
Dr. Kachooie's Report, dated September 28, 1994
Dr. M. Fazl's Report, dated September 28, 1994 (Sunnybrook Health Science Centre Records)
Clinical Notes and Records of Dr. Chow
Clinical Notes and Records of Dr. Wortzman
Clinical Notes and Records of Dr. Shaul
Clinical Notes and Records of Dr. Corrin
Dr. Guirgis' Report of December 7, 1993 and his CNR's
Dr. Zare-Parsi's Reports dated, April 15, 1994, October 11, 1994 and May 15, 1994
Clinical Notes and Records of Dr. Schacter
The Records of Sheppard-Leslie Chiropractic Clinic
Clinical Notes and Record of Dr. Bastian
Dr. Silverstein's Reports dated, October 6, 1994 and October 26, 1994
Dr. Houston's Report dated, June 8, 1993, August 17, 1993, October 18, 1993, December 10, 1993 - along with Dr. Boozary's Report of October 17, 1994
Dr. Cameron's Report dated, June 11, 1995
Scarborough General Hospital Records
OHIP Records - from May, 1994 to May 1995