Case Summary

The applicant was injured in a motor vehicle accident and sought ongoing income replacement benefits (IRBs) from his insurer. The arbitrator found that the applicant met the 'own occupation' disability test for the first 104 weeks, relying heavily on functional capacity evaluations that demonstrated his inability to perform the heavy lifting required by his pre-accident job. However, the arbitrator concluded that the applicant did not meet the 'any occupation' test for benefits beyond the 104-week mark, citing concerns about his credibility regarding the extent of his pain and his motivation to return to work. The issues of a special award for the insurer's delay in paying benefits and pre-judgment interest were deferred for further written submissions.