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Applicant removed from Minor Injury Guideline due to chronic pain; treatment plans and interest awarded.
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 Tribunal found that the applicant demonstrated she suffers from a chronic pain condition with functional impairment, warranting removal from the MIG.
The Tribunal ordered the respondent to pay for a psychological assessment and a chiropractic treatment plan, finding them reasonable and necessary.
The applicant was also awarded interest on overdue payments.
Accident benefits denied; applicant failed to prove injuries warranted removal from the Minor Injury Guideline.
The insurer denied the claims on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG) and the funding limits had been exhausted.
The applicant argued she should be removed from the MIG due to pre-existing carpal tunnel syndrome, chronic pain, and psychological injuries.
The Tribunal found the applicant failed to provide compelling medical evidence that her pre-existing condition prevented maximal recovery within the MIG, or that her physical and psychological injuries were more than minor sequelae.
As the MIG limits were exhausted, the disputed treatment plans and claim for interest were dismissed.
Applicant's injuries confined to Minor Injury Guideline; only initial physiotherapy treatment plans approved.
The applicant sought statutory accident benefits following a motor vehicle accident, including five physiotherapy treatment plans, a chronic pain assessment, and a functional impairment evaluation.
The Tribunal found that the applicant failed to prove her physical or psychological injuries fell outside the MIG, preferring the respondent's independent medical examination reports over the applicant's experts.
The Tribunal approved the first two physiotherapy treatment plans as reasonable and necessary, subject to the $3,500 MIG limit, but denied the remaining plans and assessments due to a lack of objective medical evidence.
The applicant was awarded interest on the approved plans but denied a special award for unreasonable delay.
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