The applicant was injured in a motor vehicle accident and sought statutory accident benefits for a chronic pain program and assessment.
The respondent insurer denied the benefits, arguing the injuries fell within the $3,500 Minor Injury Guideline (MIG) cap and that the chronic pain was not caused by the accident.
The Tribunal found that the applicant suffered from pre-existing chronic pain that was exacerbated by the accident, preventing maximal medical recovery within the MIG limits.
Relying on medical evidence, including reports from the respondent's own independent examiners, the Tribunal concluded the applicant's injuries were not predominantly minor.
The applicant was removed from the MIG and awarded the disputed treatment plans and assessment, along with interest on overdue benefits.