Caroline Theriault

The applicant was involved in a rear-end motor vehicle accident and sought statutory accident benefits, which the respondent insurer denied on the basis that the injuries fell within the Minor Injury Guideline (MIG).

The applicant argued that a full-thickness tear in his right shoulder, chronic pain, and psychological impairments warranted treatment outside the MIG.

The Tribunal found that the shoulder tear pre-dated the accident and that the applicant did not meet the criteria for chronic pain or a psychological impairment.

Consequently, the applicant's injuries were deemed minor, and the disputed treatment and assessment plans were not reasonable and necessary as they exceeded the $3,500 MIG funding limit.

The application was dismissed.

The applicant was involved in a motor vehicle accident and sought statutory accident benefits, claiming she sustained a catastrophic impairment due to a mental or behavioural disorder.

The Tribunal applied the Pastore test and found that the applicant suffered from class 4 (marked) impairments in activities of daily living, social functioning, and adaptation, meeting the threshold for catastrophic impairment.

The Tribunal also awarded $4,077.72 in attendant care benefits with interest, but dismissed the claim for a special award under s. 10 of Regulation 664, finding the insurer did not unreasonably withhold payments.

The applicant sought medical and rehabilitation benefits, as well as a non-earner benefit, following a motor vehicle accident.

The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and that she did not meet the test for a non-earner benefit.

The Tribunal found that the applicant failed to prove her chronic pain was not a sequelae of her soft tissue injuries, and failed to provide compelling evidence of a pre-existing condition that would prevent maximal recovery within the MIG.

The Tribunal also found the applicant did not suffer a complete inability to carry on a normal life, as she continued to engage in many of her pre-accident activities.

The application was dismissed.