Applicant's chronic pain diagnosis removed her from the Minor Injury Guideline; majority of treatment plans approved.
The applicant was injured in a motor vehicle accident and sought medical benefits and the cost of an assessment from the respondent insurer.
The respondent denied the claims, arguing the applicant's injuries fell within the Minor Injury Guideline limit of $3,500.
The adjudicator found that the applicant's injuries did not fall within the Guideline because she suffered from chronic pain that was more than a sequelae of a predominantly minor injury.
The adjudicator approved four of the six disputed treatment plans as reasonable and necessary, noting they provided pain relief and increased function, but denied two plans that were either duplicative or showed minimal progress.
The applicant was awarded interest on overdue payments, and both parties' requests for costs were dismissed.
OLATOntario Licence Appeal TribunalFeb 9, 2018
