Applicant removed from Minor Injury Guideline due to psychological injuries; physical treatment plans denied due to pre-existing conditions.
The applicant sought statutory accident benefits following a motor vehicle accident.
The insurer denied several treatment and assessment plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Licence Appeal Tribunal found that the applicant sustained an Adjustment Disorder with Mixed Anxiety and Depressed Mood as a result of the accident, removing her from the MIG.
Consequently, the 2020 psychological assessment and treatment plans were deemed reasonable and necessary.
However, the tribunal denied the physical and chronic pain treatment plans, finding that the applicant's ongoing physical complaints were related to pre-existing degenerative issues rather than the accident.
The tribunal also awarded the applicant $1,612.79 under section 10 of O. Reg. 664, finding the insurer unreasonably delayed payment by refusing to accept the uncontested psychological assessment report.
OLATOntario Licence Appeal TribunalJun 6, 2022
