Insured entitled to treatment outside the Minor Injury Guideline due to pre-existing condition and shoulder tear.
The applicant was injured in a motor vehicle accident and sought statutory accident benefits for a job demands analysis.
The respondent insurer denied the treatment plan, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Licence Appeal Tribunal found that the applicant's injuries were not predominantly minor, relying on medical evidence of a labral tear and a pre-existing C7 nerve root condition that would prevent maximal recovery under the MIG.
The Tribunal ordered the respondent to pay the remaining balance of the treatment plan and interest on the overdue payment, but denied the applicant's request for costs.
OLATOntario Licence Appeal TribunalAug 4, 2017
