Applicant removed from Minor Injury Guideline due to shoulder tear, but treatment plans denied.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits.
The respondent insurer denied certain treatment plans, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant sustained a full thickness tear of her right shoulder as a result of the accident, which is not a minor injury, and therefore she was not subject to the MIG.
However, the Tribunal held that the applicant was barred from disputing a 2019 treatment plan due to the expiry of the two-year limitation period.
Furthermore, the applicant failed to meet her onus to prove that the proposed chronic pain and orthopaedic assessments were reasonable and necessary.
OLATOntario Licence Appeal TribunalDec 2, 2024
