Applicant removed from Minor Injury Guideline due to chronic pain syndrome; partial medical benefits awarded.
The applicant was injured in a motor vehicle accident and sought medical and rehabilitation benefits, which the insurer denied on the basis that her injuries fell within the Minor Injury Guideline (MIG).
The Licence Appeal Tribunal found that while the applicant's physical injuries were predominantly minor, she demonstrated on a balance of probabilities that she suffers from chronic pain syndrome with a psychological component, warranting removal from the MIG.
The Tribunal ordered payment for one physiotherapy treatment plan, psychological assessment and treatment, and prescription expenses, finding them reasonable and necessary to address her chronic pain.
The remaining treatment plans and assessments were denied as redundant or unnecessary, and the claim for a special award was dismissed as the insurer had a genuine dispute.
OLATOntario Licence Appeal TribunalMar 6, 2020
