Neutral Citation: 1997 ONICDRG 153

OIC A95-000292

ONTARIO INSURANCE COMMISSION

BETWEEN:

JOHN G. BAKER

Applicant

and

NON-MARINE UNDERWRITERS, MBRS. OF LLOYD'S

Insurer

DECISION

Issues:

The Applicant, John G. Baker, was injured in a motor vehicle accident on September 24, 1992. He applied for and received statutory accident benefits from Non-Marine Underwriters, Mbrs. of Lloyd's ("Lloyd's"), payable under Ontario Regulation 672.¹ Lloyd's terminated weekly income benefits on September 24, 1995. Mr. Baker claims ongoing entitlement to these benefits under section 12(5)(b) of the Schedule. The parties were unable to resolve their dispute through mediation. Mr. Baker applied for arbitration under the Insurance Act, R.S.O. 1990, c.I.8 (the Act), as amended.

The issues in this hearing are:

1. When does the section 12(5)(b) test commence?

2. Is Mr. Baker entitled to weekly income benefits under section 12(5)(b) of the Schedule?

3. Is Mr. Baker entitled to a special award pursuant to section 282(10) of the Act?

Mr. Baker also claims interest on any amounts owing and his expenses incurred in the arbitration proceeding.

Result:

1. The section 12(5)(b) test commences after 156 weeks of disability.

2. Mr. Baker is not entitled to weekly income benefits under section 12(5)(b) of the Schedule.

3. Mr. Baker is not entitled to a special award.

4. Mr. Baker is entitled to his expenses incurred in this arbitration proceeding.

Evidence and Findings:

Background:

At the time of the accident of September 24, 1992, Mr. Baker was 47 years old, married, with two children, aged 13 and 16 years. Mr. Baker has been a construction millwright and a member of the Millwrights and Machine Erectors Union since 1965. At the time of the accident, he was working at the Lakeview Power Generation Station refurbishing turbines. He had been working at this site for one and-a-half years on a contract with Houden Group Canada.

The accident occurred at an intersection, while Mr. Baker was attempting to make a left turn. His car was rear-ended by another vehicle. Mr. Baker was jolted by the impact; however, his body did not hit the interior of his vehicle. At the time, he did not feel any pain. He went home after the accident.

However, the next day, Mr. Baker felt pain in his lower back. He visited his family doctor, Dr. Peter Dobson. Dr. Dobson diagnosis was "back pain - acute and chronic." (Mr. Baker had seen Dr. Dobson a few weeks prior to the accident with complaints of low back pain and Dr. Dobson had referred him to Dr. Newall, an orthopaedic specialist.) Dr. Dodson gave Mr. Baker a prescription for pain medication and referred him to the Canadian Back Institute (CBI). Dr. Dodson also told him to attend at his pre-arranged appointment with Dr. Newall.

Mr. Baker went to work the following day. He told the foreman about the accident and his low back pain. He did his regular duties for about six weeks; however, because of persistent low-back pain, he was then assigned to lighter duties.

On November 24, 1992, Mr. Baker was laid off, along with all other employees of Houden Group Canada. He was recalled ten days later on December 3, 1992; however, by this time, his low back condition had deteriorated significantly and he was unable to return to work. He has not returned to his occupation as a millwright or to any other employment since November 24, 1992.

Since the accident, in addition to seeing Dr. Dobson on a regular basis, Mr. Baker has been examined and assessed by a number of health care practitioners. He has received various forms of rehabilitation treatment and vocational rehabilitation. Mr. Baker testified that despite the treatments, he has seen no improvement in his low back pain since the accident.

Lloyd's paid Mr. Baker weekly income benefits up to September 24, 1995, being 156 weeks post-accident, under section 12(1) of the Schedule. This section requires the insurer to pay weekly income benefits during the period in which the insured person suffers a substantial inability to perform the essential tasks of his or her occupation or employment, as a result of injuries sustained in the accident. Lloyd's does not dispute that Mr. Baker is unable to work as a millwright which, by all accounts, is a job with heavy physical demands. However, Lloyd's contended that Mr. Baker does not meet the stricter test of disability under paragraph 12(5)(b) of the Schedule for any period after September 25, 1995.

When does the test for disability under section 12(5)((b) commence?

Paragraph 12(5)(b) provides that the insurer is not required to pay the insured weekly income benefits "for any period in excess of 156 weeks," unless the insured person meets the stricter test of disability outlined in the section. The parties were not in agreement as to what the phrase "in excess of 156 weeks" means. During their submissions, they asked me to address this issue.

Counsel for Mr. Baker argued that the phrase "in excess of 156 weeks" refers to a period of 156 weeks of disability. He submitted that this interpretation allows for delayed onset of disability and runs for 156 weeks of disability from the date when the person first became disabled. In this case, counsel for Mr. Baker argued that Mr. Baker is not required to meet the test under section 12(5)(b) until December 4, 1995 - the end of the 156th week from the onset of his disability.

Counsel for Lloyd's submitted that the period of 156 weeks starts from the date of the accident and ends 156 weeks from the accident date. Therefore, counsel contended that Mr. Baker's entitlement to benefit under subsection 12(1) ended on September 25, 1995; and, after that date, he must meet the test under paragraph 12(5)(b) in order to be entitled to further benefits.

There have been different approaches to the interpretation of the words "for any period in excess of 156 weeks" in paragraph 12(5)(b). Some arbitration cases have held that the 156 weeks runs continuously from the date of the accident² while other cases have held 156 weeks to be "156 weeks of disability," allowing delayed onset or breaks to extend the initial period.³ The words have also been interpreted to mean "156 weeks of payment," in which the receipt of collateral payments interrupts the running of the 156 week period.⁴

This issue has been the subject of a recent appeal decision by the Director's Delegate in Pina Coles and Dominion of Canada General Insurance Company.⁵ The Director's Delegate approved the approach in Caruso⁶ in which Arbitrator Shemin Manji construed 156 weeks as meaning 156 weeks of disability. The Director's Delegate stated that "the 156 weeks are 156 weeks in respect of which an insurer is required to pay a weekly benefit under subsection 12(1)," thus supporting the view that the 156 weeks run from the date of the onset of disability.

I adopt the reasoning in Caruso and the appeal decision in Coles. In my view, the interpretation that the phrase "in excess of 156 weeks" means "in excess of 156 weeks of disability" best reflects the intention of the legislature and the scheme of the Schedule.

I find that the onset of Mr. Baker's disability was December 3, 1992, when he was unable to return to work. Accordingly, I find that the stricter test of disability under section 12(5)(b) does not apply to Mr. Baker until December 4, 1995.

Entitlement to Ongoing Weekly Income Benefits:

In order to succeed in his claim for ongoing weekly income benefits, Mr. Baker must adduce evidence sufficient to establish, on a balance of probabilities, that he meets the test set out under subsection 12(5)(b) of the Schedule. He must prove that his injuries resulting from the accident continuously prevent him from engaging in any occupation or employment for which he is reasonably suited by education, training or experience.

Education, Training and Experience:

Mr. Baker left high school in 1964 at grade 11. His first job was as a printing apprentice at Ryerson Press, making lead moulds. He left that job after a few months. Mr. Baker testified that he does not have those skills today. Mr. Baker received his certification as a millwright in 1969 after completing a four-year apprenticeship programme at George Brown College. Since that time, he has been steadily employed as a millwright and has worked at various sites through contracts obtained by his union. He has worked on a variety of projects installing large machines, turbines, conveyor belts, ovens, blast furnaces and factory floors.

He installed machinery and equipment according to layout plans, blue prints and other drawings in industrial establishments. He used hoists, lift trucks, hand tools, power and precision tools such as micrometers to measure, align, and install the machines and equipment.

Mr. Baker was paid approximately $30.00 per hour when he worked with Houden Group Canada. He worked mainly days, from 10 to 12 hours a day, often seven days a week.

The work of a construction millwright is heavy and physically demanding, involving heavy lifting, repetitive bending, stooping, kneeling, crouching, reaching, as well as prolonged standing.

Mr. Baker has worked as a foreman for about seven years, supervising employees and the installation of machines. He has served as a union steward and representative on Health and Safety Committees. He acquired experience in liaising between union and management and settling labour disputes. He sat in the union executive for nine years as Warden, and participated in decision-making.

In addition to his qualifications as a millwright, Mr. Baker is also a licensed gas fitter. He obtained his gas fitter licence in 1970 after taking a course at a college. He worked for Blue Flame for a short time installing gas furnaces.

During the late 1970s, while working as a millwright, Mr. Baker also owned and operated a hotel and bar business with a partner. The business was not successful and it was sold in 1982. Mr. Baker testified that he was the manager of the hotel, which had five employees who reported to him. He testified that he worked mainly at night, at the bar, as a bouncer or counting cash, and was not much involved in administrative duties.

In addition to his training as a millwright and gas fitter, Mr. Baker has taken formal training in small engine repair, blue print reading, wood carving and cabinet making.

After the accident, as part of his vocational rehabilitation, Mr. Baker took a typing course and a course in computerized drafting (AutoCAD). He passed the course and received a certificate.

Medical Evidence:

Mr. Baker testified that he suffered from low back pain prior to the accident; however, he denied Lloyd's suggestion that he has had a 20-year continuous history of back pain. He said he did not know the cause of this pre-existing pain. He testified that his prior back problem did not prevent him from working.

Dr. John McLean, Mr. Baker's chiropractor since 1981, testified that Mr. Baker had come to him periodically complaining of low-back problem, and he has provided him with chiropractic and naturopathic treatments. Dr. McLean testified that after the accident, Mr. Baker's back problem became more severe, requiring different modalities of treatment. After the accident, he used traction and acupuncture treatment to help him deal with his pain. Dr. McLean testified that as far as he knew, the car accident was the only thing that happened to Mr. Baker that could account for the worsening of the pain after September 24, 1992.

Dr. Dobson, who has been Mr. Baker's family physician since 1987, indicated in his report dated November 18, 1996 that Mr. Baker first complained of mild back pain on November 14, 1991. Approximately three weeks prior to the accident, Mr. Baker saw Dr. Dobson with worsening low back pain which interfered with his sleep, but not with his ability to work. Dr. Dobson referred him to Dr. Newall "because of the unusual nature of his pain (worse at night but able to work hard all day) and the absence of significant physical findings."

Mr. Baker was first examined by Dr. Newall on October 28, 1992, approximately five weeks after the accident. On physical examination, Dr. Newall found nothing unusual. The x-rays of Mr. Baker's lumbosacral spine revealed minimal degenerative changes at L4-5. A CT scan of Mr. Baker's spine done on November 30, 1992 showed substantial facet joint changes at the L4-5 level but did not demonstrate any significant disc protrusions. To further investigate Mr. Baker's continued complaint of severe low back pain, Dr. Newall recommended facet joint block.

Mr. Baker reported decreased pain after the first facet joint block treatment, but a repeat of the procedure failed to provide him with any relief. After all the usual forms of conservative treatment failed to alleviate Mr. Baker's pain, Dr. Newall discussed the possibility of a spinal operation. However, this procedure was never done, as Mr. Baker was not keen on an operation that only offered him a ten per cent chance of success.

In the fall of 1992, Mr. Baker attended the Canadian Back Institute for ten weeks, where he underwent a comprehensive rehabilitation program. The CBI report of February 18, 1993 indicates that Mr. Baker was well enough to return to his pre-accident employment; however, Mr. Baker testified that the treatments there afforded him only temporary relief, and that his low back pain did not change significantly.

On September 28, 1993, Mr. Baker was examined by Dr. L. Mascarenhas, a disability consultant, at Lloyd's request. Dr. Mascarenhas reviewed all of the medical information to date and took a detailed history from Mr. Baker, including the nature and extent of his pre-existing low back pain. Dr. Mascarenhas concluded that Mr. Baker was not capable of returning to his pre-accident employment at that time. Dr. Macarenhas stated:

My physical examination today was essentially unremarkable from a neurological and range of motion perspective, however he impressed me as a gentleman with legitimate symptomatology, and there was no element of symptom magnification. Given the fact that his job was that of a millwright, it would be difficult for him to perform the physical tasks of his occupation."

Dr. Mascarenhas suggested that Mr. Baker receive vocational rehabilitation to assist him in returning to the workforce within the restrictions of his impairment.

In December 1993, Mr. Baker was involved in a second car accident with only a temporary aggravation of his condition. Mr. Baker continued to complain of pain, and in February, 1994, Dr. Dobson referred him to Dr. M. Ford, an orthopaedic specialist at the Orthopaedic and Arthritic Hospital in Toronto. Dr. Ford made no significant physical findings regarding Mr. Baker's low back. He confirmed the diagnosis of the other doctors that as a result of the accident Mr. Baker had sustained soft tissue injuries to his low back. He recommended an active program of exercise.

The medical evidence indicates that at the beginning of 1994, although Mr. Baker had achieved a relatively full range of motion in his back, he still was not capable of prolonged standing, prolonged sitting, prolonged forward flexion, heavy repetitive lifting and carrying - all of which were the physical demands of his pre-accident employment.

In mid-1994, Lloyd's retained Voc-Care Rehabilitation Management Inc.("Voc-Care") to assist in Mr. Baker's rehabilitation management, both medical and vocational.

Voc-Care referred Mr. Baker to the Health Recovery Clinic (HRC) where he underwent a pain management programme, vocational assessment and testing, an active occupational therapy programme and career counselling.

Mr. Baker enrolled in a Functional Restoration and Pain Management Program which included physical exercise, work hardening, relaxation training, and individual and group counselling. The treatment team consisted of a psychologist, physiotherapist, kinesiologist and behavioural therapist. The Voc-Care report dated September 8, 1994 indicates that Mr. Baker completed this program successfully on August 26, 1994, and "has been able to maintain a significantly improved level of functioning both at the clinic and with essential tasks within the home." Mr. Baker was discharged from the program with home exercise. The focus of Mr. Baker's rehabilitation then shifted to identifying a suitable employment consistent with his physical limitations.

After the termination of his weekly income benefits, Mr. Baker was examined by two orthopaedic surgeons. On September 16, 1996, he was seen by Dr. D.J. Ogilvie-Harris at the request of his counsel. In his report of October 1, 1996, Dr. Ogilvie-Harris concluded that Mr. Baker would be unable to return to his previous job and that he would have to seek work in a lighter capacity. He confirmed the specific restrictions to be: repetitive bending, repetitive lifting, repetitive twisting or turning, carrying heavy objects, prolonged standing, climbing and reaching overhead.

On July 31, 1996, Mr. Baker was examined by Dr. H. Cameron, at Lloyd's request. Dr. Cameron testified at the hearing. In addition, his report dated July 31, 1996 was filed in evidence. In his testimony, Dr. Cameron questioned Mr. Baker's claim and the conclusion of other medical professionals that his low back problems were caused by the accident. Dr. Cameron felt that Mr. Baker's problem is probably degenerative disc disease which pre-dated the motor vehicle accident, and was not aggravated by the accident. With respect to his functional capacity, Dr. Cameron initially indicated in his report that he felt Mr. Baker was not disabled from his pre-accident employment due to low back pain. However, in his testimony, he agreed that Mr. Baker "might be disabled" from returning to his occupation as a millwright.

In summary, I find on the medical evidence that while Mr. Baker is unable to engage in the heavy tasks of a millwright, his injuries do not prevent him from performing lighter, more sedentary duties.

Causation:

Lloyd's submitted that Mr. Baker's disability was not caused by the accident. It suggested that Mr. Baker's pre-existing low back condition is responsible for his disability. Mr. Baker admitted that he did complain of low back pain prior to the accident; however, at the time of the accident, he was fully functional and was able to perform all of the essential tasks of his employment as a millwright. The majority of the medical evidence, including the report of Dr. Mascarenhas who conducted the insurer's examination in September 1993, indicates that Mr. Baker's disability was caused by the motor vehicle accident.

After reviewing the relevant medical records, I find that Mr. Baker had pre-existing low back pain; however, as Dr. Mascarenhas stated in his report, "this was relatively manageable, and did not interfere with his vocation and avocational pursuits." Mr. Baker's testimony that at the time of the accident he was in relatively good health and, despite his low back problems, able to work as a millwright, has not been challenged by Lloyd s. His testimony is supported by the medical evidence and the testimony of his wife.

Accordingly, I find that at the time of the accident Mr. Baker was able to perform the essential tasks of his occupation as a millwright without substantial limitations, despite his low back pain. I find that as a result of the accident Mr. Baker suffered an aggravation of his low back problem.

I find that the accident is a significant contributor to his injury and is responsible for his post-accident disability

Suitable employment:

As indicated earlier in this decision, the onus to prove disability rests with the applicant. The nature and extent of evidence that an applicant must adduce to discharge this onus depend on the circumstances of each case. In Murray and Wawanesa Mutual,⁷ Arbitrator Lawrence Blackman summarized arbitration cases which commented on the Applicant's onus as follows:

Recent arbitration decisions have grappled with what is the "positive obligation"⁸on insureds. Arbitrator Evans stated that applicants as part of discharging the onus of proof "must explore career options."⁹ Arbitrator Seife held that "the applicant must identify some sort of 'suitable' employment, describe the physical demands of the work and demonstrate with credible evidence that their injuries continuously prevent them from engaging in such employment."¹⁰ Arbitrator Manji in the Caruso decision required the Applicant (if unable to adduce strong medical evidence of total disability) to provide some evidence that he or she "has made a bona fide effort to identify, try to find or attempt some sort of 'suitable' employment but failed because his or her injuries continuously prevent him or her from engaging in such employment."

Arbitrators have acknowledged that subsection 12(5)(b) encompasses a broader range of inquiry than subsection 12(1), and that the issue of disability is considered not merely in terms of the occupation or employment engaged in at the time of the accident, but in terms of any occupation or employment for which the insured person is reasonably suited by education, training or experience.

What is "suitable" employment? Arbitrators have suggested several guidelines for determining what "suitable" employment is. I have summarized them in my decision in Wigle¹¹ as follows:

1. The question of suitable employment in every case is a question of fact: the work must be suitable for that applicant, viewed fairly and realistically in the context of his or her educational and employment background.

2. Suitable work is not limited to what the applicant was doing at the time of the accident, provided that it is not unrelated to his or her previous experience. However, work is not necessarily suitable because an applicant has done a stint of it in the past. If the job is substantially different in nature, status, or remuneration it may not be an appropriate alternative.

3. In deciding suitable employment, one must consider such factors as the nature and status of the work compared with what the applicant did before, the hours of work and level of remuneration, the applicant's employment experience and length of time spent in different jobs, his or her age, and his or her qualifications and technical training and know-how.

4. The primary focus is on an applicant's functional limitations; however, job-market considerations are relevant in determining suitable employment.

I adopt these principles for the purposes of this case.

As I indicated in Sherre Maas and State Farm Mutual Automobile Insurance Company,¹² before stopping benefits, the insurer must allow the insured person a reasonable opportunity to establish that the injury continuously prevents him/her from engaging in any suitable employment. The insurer also has a responsibility to assist the insured person in this regard, including providing any vocational retraining required to prepare the person to return to the workforce. However, the insurer has no obligation to find a job for the applicant.

In this case, Lloyd's rehabilitation experts began to address the question of what employment might be suitable for Mr. Baker at least one year prior to the 156-week mark of the accident. Lloyd's conducted an assessment of Mr. Baker's residual functional abilities; it performed an analysis of transferrable skills, identified alternate employment, and afforded him vocational training of his own choice. Mr. Baker indicated to Lloyd's that the AutoCAD course was consistent with his experience, physical restrictions and expectation of remuneration.

As discussed above, while Mr. Baker's chief employment through the years prior to the accident was one of millwright, he has a number of transferrable skills that can be applied to other occupations, including those enumerated in the transferrable skills analysis report.

Mr. Michael McNeill, a rehabilitation consultant retained by Lloyd's, testified that he conducted a computerized transferrable skills analysis to determine suitable vocational alternatives for Mr. Baker. These include millwright foreman, heavy equipment inspector, industrial machinery and equipment salesperson, production line inspector, material coordinator, process control equipment repairer, small engine repairer, and computer-aided dispatch clerk. Mr. McNeill testified that these jobs are classified as light and require minimum on the job training.

Mr. Baker claims that neither the alternate jobs identified above nor the AutoCAD job would be appropriate for him, given his physical limitations. However, I heard no evidence to support this contention. The medical evidence indicates that he is capable of engaging in light-duty jobs. Mr. Baker's claim is that the only occupation he has the experience and training to perform is that of a millwright. Mr. Baker admitted in cross-examination that he did not attempt to look for a job after obtaining his certificate in the AutoCAD course. He has not meaningfully explored other career options, nor has he attempted to engage in any sort of suitable employment. Therefore, I cannot accept Mr. Baker's claim that the only occupation that is suitable for him is that of a millwright.

Having considered the entire evidence in this case, I am not satisfied that Mr. Baker has proved that he suffers the requisite disability. While the evidence indicates that he is unable to engage in the heavy duties of a millwright, I find that, on the balance of probabilities, he has not established that his injury continuously prevents him from engaging in any occupation or employment for which he is reasonably suited by virtue of his educational and vocational background.

Special Award:

Section 282(10) of the Insurance Act states:

(10) If the arbitrator finds that an insurer has unreasonably withheld or delayed payments, the arbitrator, in addition to awarding the benefits and interest to which an insured person is entitled under the Statutory Accident Benefits Schedule, shall award a lump sum of up to 50 per cent of the amount to which the person was entitled at the time of the award together with interest on all amounts then owing to the insured (including unpaid interest) at the rate of 2 per cent per month, compounded monthly, from the time the benefits first became payable under the Schedule.

A special award is based on the amount to which the Applicant is entitled at the time of the award. I have concluded in this case that Mr. Baker is not entitled to additional weekly benefits. Therefore, I cannot make a lump sum award. In any case, even if I were to find that I have the authority to make such an award, I do not find that Lloyd's has unreasonably withheld or delayed payments.

In the case of Wayne Plowright and Wellington Insurance,¹³Arbitrator Julaine Palmer set out what she considered would constitute unreasonable conduct by an Insurer:

"Unreasonable" behaviour by an Insurer in withholding or delaying payments can be seen as behaviour which was excessive, imprudent, stubborn, inflexible, unyielding or immoderate.

I agree with this approach and adopt it for the purposes of this case.

I have determined that Mr. Baker is not entitled to weekly income benefits under paragraph 12(5)(b). Accordingly, I find that Lloyd's acted reasonably in terminating his benefits, despite my finding that the disability test under paragraph 12(5)(b) does not apply until Mr. Baker had been disabled under subsection 12(1) for 156 weeks. I find Lloyd's premature termination of benefits was made in good faith, on a plausible interpretation of the legislation.

Mr. Baker and Mr. Bill Manners, Lloyd's claims adjuster, testified about the pattern of payment of weekly income benefits. Mr. Baker claimed that Lloyd's was consistently late in paying him. Mr. Manners testified that while Lloyd's was late in paying benefits during the initial few months, for the most part, Lloyd's paid regularly, and with accrued interest on all late payments.

Having reviewed the oral testimony as well as a handwritten schedule of payments filed into evidence, I find that Lloyd's did delay some payments; however, I am not satisfied that Lloyd's conduct was so excessive or improper as to attract the sanctions of a special award. Therefore, Mr. Baker's claim for a special award is denied.

Expenses:

Although Mr. Baker was not successful in his arbitration, his claim was not entirely without merit. I have decided to exercise my discretion under section 282(11) of the Act to grant Mr. Baker his expenses in respect of this arbitration.

Order:

1. The section 12(5)(b) test commences after 156 weeks of disability.

2. Mr. Baker is not entitled to weekly income benefits under section 12(5)(b) of the Schedule.

3. Mr. Baker is not entitled to a special award.

4. Mr. Baker is entitled to his expenses incurred in this arbitration proceeding.

August 15, 1997

Asfaw Seife

Arbitrator

Date

APPENDIX A

Hearing:

The hearing was held at the offices of the Ontario Insurance Commission in North York, Ontario, on December 2, 3, 4 and 5, 1996, before me, Asfaw Seife, Arbitrator.

Present at the Hearing:

Applicant:

John G. Baker

Mr. Baker's

David F. Longley

Representative:

Barrister and Solicitor

Lloyd's's

Elizabeth Fanjoy

Representative:

Barrister and Solicitor

Witnesses:

John Baker

The Applicant

Joy Baker

The Applicant's Wife

Dr. H. Cameron

Orthopaedic Surgeon

Michael McNeill

Rehabilitation Consultant

Dr. John McLean

Chiropractor

Bill Manners

Insurance Adjuster

Exhibits:

1. Joint Medical Brief - 27 Tabs

2. Insurer's Brief of Documents

3. Letter from G. Benton, Project Manager, Howden Group Canada dated January 26, 1993

4. Appraisal Report from Paragon Appraisals Limited, dated October 6, 1992

5. Letter from Ronald Miller, Business Manager, Millwrights' & Machine Erectors' Local 2309, dated November 25, 1996

6. Dr. Mclean's clinical notes - May 1981 to September 1992

7. Payment Schedule (original)

8. Payment Schedule (copy)

Footnotes

1. 1Prior to January 1, 1994, Ontario Regulation 672 was called the No-Fault Benefits Schedule. After that date it became the Statutory Accident Benefits Schedule —Accidents On or Between June 22, 1990 and December 31, 1993. In this decision, the term "Schedule" will be used to refer to Regulation 672.
2. 2Lafleur and Zurich Insurance Company (May 11, 1995), OIC A-004141
3. 3Whyte and Metropolitan Insurance (April 30, 1996), OIC A-00927; Caruso and Guarantee Company of North America (May 9, 1996), OIC A-006856; Gulizia and Dominion of Canada General Insurance Company (January 13, 1997), OIC A-000359 (under Appeal)
4. 4Pina Coles and Dominion of Canada General Insurance (February 13, 1995), OIC A-007416. Reversed on appeal.
5. 5July 28, 1997 (OIC Appeal P-007416)
6. 6See footnote 3, above.
7. 7Murray and Wawanesa Mutual Insurance Company (August 23, 1996), OIC A-003224
8. 8Gagnon and Jevco Insurance Company (May 1, 1996), OIC A-015357
9. 9Gagnon, ibid, at page 5
10. 10Wigle and Royal Insurance Company of Canada (January 12, 1996), OIC A-012312
11. 11Ibid
12. 12(October 16, 1996), OIC A-015935
13. 13Wayne Plowright and Wellington Insurance (October 29, 1993), OIC File No. A-003985