Applicant held to MIG limit, but defective denial triggers 'shall pay' provision for psychological assessment.
The applicant sought statutory accident benefits following a motor vehicle accident.
The Tribunal found the applicant's injuries were predominantly minor and subject to the $3,500 Minor Injury Guideline (MIG) limit, as the applicant failed to provide compelling medical evidence of a pre-existing condition or psychological impairment warranting removal.
A treatment plan for physical therapy was denied because the MIG limit was exhausted.
However, the Tribunal ordered the respondent to pay for a $2,200 psychological assessment once incurred, finding the respondent's denial was defective under s. 38(8) of the Schedule because it relied on an unrelated, previously settled claim, thereby triggering the 'shall pay' provision.
Claims for a special award under s. 10 of Reg. 664 were dismissed as the respondent's error was not highhanded or unreasonable.
OLATOntario Licence Appeal TribunalOct 10, 2025
