Dr. G. Challis

The applicant sought accident benefits following a motor vehicle accident, claiming removal from the Minor Injury Guideline (MIG) due to chronic pain and psychological impairments.

The Tribunal found that the applicant's injuries were predominantly minor.

Relying on the respondent's section 44 physiatry and psychological assessments, the Tribunal concluded there was no objective evidence of chronic pain with functional impairment or a psychological condition.

As the applicant remained within the MIG, the disputed treatment plans were not payable, and claims for an award and interest were dismissed.

The applicant sought non-earner benefits and funding for a psychological assessment following a motor vehicle accident.

The respondent denied the claims, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG) and that he did not suffer a complete inability to carry on a normal life.

The Tribunal found that the applicant, who continued to work multiple jobs post-accident, failed to demonstrate a complete inability to carry on a normal life, disqualifying him from non-earner benefits.

Furthermore, the Tribunal determined that the applicant's physical and psychological injuries were minor and subject to the MIG's $3,500 funding limit.

The request for a psychological assessment was denied as it fell outside the MIG methodologies, and no interest was awarded.

The applicant sought payment for two physiotherapy treatment plans following a motor vehicle accident.

The respondent denied the plans on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and were subject to the $3,500 cap.

The applicant argued she suffered chronic pain and psychological damage taking her outside the MIG.

The Tribunal found the applicant failed to prove on a balance of probabilities that her injuries were more than predominantly minor, preferring the objective clinical notes of her family physician over her chiropractor's records.

The application for benefits was dismissed.

The applicant sought a special award under s. 282(10) of the Insurance Act, alleging that the insurer unreasonably denied two occupational therapy treatment plans.

In a previous hearing, an arbitrator found the treatment plans were reasonable and necessary but denied the special award.

On appeal, the special award issue was returned for redetermination.

The arbitrator found that the insurer did not act unreasonably in relying on its own assessors' reports to deny the benefits.

The insurer's reliance on the reports of its occupational therapist and psychologist was not immoderate or inflexible, especially given gaps in the applicant's medical evidence and questions regarding causation.

The claim for a special award was dismissed.