4 total
Applicant kept in MIG, but awarded IRBs due to insurer's failure to timely respond to disability certificate.
The applicant sought accident benefits following a motor vehicle accident, claiming removal from the Minor Injury Guideline (MIG) due to a concussion and psychological impairment, as well as entitlement to income replacement benefits (IRBs) and various treatment plans.
The Tribunal found the medical evidence did not support a concussion or psychological impairment, keeping the applicant within the MIG and denying the treatment plans.
Although the applicant failed to meet the substantive test for IRBs, the Tribunal awarded IRBs from February 27, 2023, to April 14, 2023, because the insurer failed to respond to the disability certificate within the required 10 business days under s. 36(4) of the Schedule.
Claims for an award were dismissed.
Accident benefits claim dismissed; applicant failed to prove chronic pain or psychological impairments warranted MIG removal.
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 argued she should be removed from the MIG due to chronic pain with functional impairment and psychological impairments.
The Tribunal found the applicant did not meet her burden to prove her injuries fell outside the MIG, noting inconsistencies in her expert reports and a lack of documented functional impairment in her primary care records.
As the MIG applied, the disputed treatment plans were not payable.
Claims for interest, a special award, and costs were also dismissed.
Applicant's injuries remained within the Minor Injury Guideline; claims for psychological assessment and award dismissed.
The applicant claimed she suffered from psychological impairments and chronic pain warranting removal from the MIG.
The Tribunal found that the applicant did not prove she suffered from a psychological impairment or chronic pain caused by the accident, preferring the respondent's expert evidence and the clinical notes of the applicant's family doctor.
The Tribunal concluded the applicant's injuries remained within the MIG, dismissing the claims for the psychological assessment, an award, and interest.
Application for accident benefits dismissed as the applicant's injuries fell within the Minor Injury Guideline.
The respondent insurer denied three treatment plans for chiropractic services on the basis that the applicant's injuries fell within the Minor Injury Guideline (MIG).
The Tribunal found that the applicant sustained predominantly minor injuries, specifically a lumbar sprain and mechanical back pain, and failed to establish chronic pain or a psychological impairment that would warrant removal from the MIG.
The Tribunal also held that the respondent's denial notices complied with s. 38(8) of the Schedule by providing sufficient medical reasons based on insurer examinations.
The application was dismissed.