Dr. S. Tu

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.

The applicant was injured in a motor vehicle accident and sought statutory accident benefits.

The respondent insurer determined the injuries fell within the Minor Injury Guideline (MIG) and refused to fund certain treatment plans.

The applicant argued that pre-existing back pain and sciatica from prior accidents precluded her recovery within the MIG.

The Tribunal found no compelling evidence that the pre-existing conditions prevented recovery, noting objective medical evidence and inconsistencies in the applicant's self-reporting to assessors.

The Tribunal concluded the applicant sustained minor injuries, was subject to the $3,500 funding limit, and dismissed the claims for additional treatment and assessments as the limit was exhausted.

The applicant sought statutory accident benefits following a rear-end motor vehicle collision.

The respondent denied several treatment plans for physiotherapy, psychological services, and physiatry assessments on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Tribunal found that the applicant suffered soft tissue injuries and did not establish that pre-existing conditions, chronic pain with functional impairment, or psychological impairments warranted removal from the MIG.

As the $3,500 MIG limit was exhausted, the disputed treatment plans were not payable.

The application was dismissed.