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Application for accident benefits dismissed; injuries found to be predominantly minor and subject to MIG limits.
The applicant sought statutory accident benefits following a motor vehicle accident.
The respondent denied the benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).
The applicant claimed his injuries, including a concussion, psychological impairments, and chronic pain, warranted removal from the MIG.
The Tribunal found insufficient objective medical evidence to support a concussion or psychological impairment diagnosis.
Applying the AMA Guides, the Tribunal also found the applicant's chronic pain did not result in a functional impairment.
The Tribunal concluded the injuries were predominantly minor and subject to the MIG limits, which had been exhausted.
The application was dismissed.
Reconsideration granted; adjudicator erred by approving treatment plans based on applicant's right to choose modality.
The respondent insurer requested a reconsideration of a Tribunal decision that found the applicant entitled to payment for two chiropractic treatment plans.
The original adjudicator had approved the plans on the basis that it was reasonable and necessary for the applicant to choose her modality of treatment.
On reconsideration, the Tribunal found this was a significant error of law, as the correct test is whether the services themselves are reasonable and necessary, supported by objective medical evidence.
The original decision regarding the chiropractic plans was cancelled and a new written hearing was ordered.
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