Sebastian Joseph

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent insurer denied the benefits on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).

The applicant argued for removal from the MIG due to pre-existing conditions, a meniscal tear, chronic pain, and psychological impairments.

The Tribunal found that the applicant failed to prove on a balance of probabilities that his injuries warranted removal from the MIG.

As the $3,500 MIG limit was already exhausted, the claims for additional physiotherapy, psychological services, and a social work assessment were dismissed.

The applicant was injured in a rear-end motor vehicle accident and sought medical and rehabilitation benefits beyond the $3,500 Minor Injury Guideline (MIG) limit, arguing that a pre-existing clavicle fracture was exacerbated, leading to chronic pain and psychological impairments.

The adjudicator found that the applicant failed to provide compelling evidence of functional impairment or disability resulting from chronic pain, noting that he continued to work and travel, and did not meet the criteria under the AMA Guides.

The adjudicator concluded that the applicant's injuries were predominantly minor and subject to the MIG limit.

As the MIG limit had been exhausted, the disputed treatment plans were denied and the application was dismissed.