Baljinder Kandola v. Economical Insurance Company, 2022 CanLII 98048

Licence Appeal Tribunal File Number: 20-011592/AABS

In the matter of an Application pursuant to subsection 280(2) of the Insurance Act, RSO 1990, c I.8., in relation to statutory accident benefits.

Between:

Baljinder Kandola

Applicant

and

Economical Insurance Company

Respondent

DECISION [AND ORDER]

ADJUDICATOR:

Richard Warr

APPEARANCES:

For the Applicant:

Linda To, Paralegal

For the Respondent:

Monika Bolejszo, Counsel

HEARD BY WAY OF WRITTEN SUBMISSIONS

BACKGROUND

1The applicant was involved in an automobile accident on May 11, 2019 and sought benefits pursuant to the Statutory Accident Benefits Schedule – Effective September 1, 2010 (including amendments effective June 1, 2016) (“Schedule”). The applicant was denied certain benefits by the respondent and submitted an application to the Licence Appeal Tribunal – Automobile Accident Benefits Service (“Tribunal”).

ISSUES IN DISPUTE

2I have been asked to decide the following issues in dispute:

1. Are the applicant’s injuries predominantly minor as defined in s. 3 of the Schedule and therefore subject to treatment within the $3,500.00 limit and in the Minor Injury Guideline (“MIG”)?

2. If the applicant’s injuries are not considered to be predominantly minor,

   i. Is the applicant entitled to a medical benefit in the amount of $197.69 ($1,297.69 less $1,100.00 approved) for physiotherapy and chiropractic services recommended by Complete Rehab Centre, as per OCF-18 submitted on October 18, 2019?

   ii. Is the applicant entitled to a medical benefit in the amount of $1,803.73 for physiotherapy and chiropractic services recommended by Complete Rehab Centre, as per OCF-18 submitted on February 3, 2020?

   iii. Is the applicant entitled to the cost of an examination in the amount of $2,460.00 for a psychological assessment recommended by Dr. Jon Mills, as per OCF-18 submitted on January 28, 2020?

   iv. Is the applicant entitled to the cost of an examination in the amount of $2,460.00 for a chronic pain assessment recommended by Complete Rehab Centre, as per OCF-18 submitted on February 19, 2020?

3. Is the applicant entitled to interest on any overdue payment of benefits?

RESULT

3Based on the evidence and submissions, I find that the applicant sustained predominantly minor injuries as defined under the Schedule. As a result, none of the treatment plans in dispute are payable.

ANALYSIS

The Minor Injury Guideline

4Section 3(1) of the Schedule defines a “minor injury” as “one or more of a sprain, strain, whiplash associated disorder, contusion, abrasion, laceration or subluxation and includes any clinically associated sequelae to such an injury and includes any clinically associated sequelae to such an injury. The terms, “strain,” “sprain,” “subluxation,” and “whiplash associated disorder” are defined in the Schedule.

Did the Applicant Sustain Injuries that are Predominantly Minor?

5On May 11, 2019, the applicant was the seat-belted driver of a sport utility vehicle. He was stopped at a traffic light when his vehicle was struck from behind. The air bags did not deploy, he did not lose consciousness or strike his head. He exited the vehicle unassisted and did not attend the hospital following the accident.

6On May 25, 2019, the applicant was examined by Dr. Rahim Jessa, a chiropractor at Complete Rehab Centre. Dr. Jessa completed Disability Certificate (“OCF-3”) listing the applicant’s most significant injuries resulting from the subject accident. ¹ These injuries were:

1. Sprain and strain of cervical spine
2. Sprain and strain of shoulder joint – Bilateral
3. Sprain and strain of thoracic spine
4. Sprain and strain of lumbar spine
5. Disorders of initiating and maintaining sleep (insomnias).

7In the OCF-3, Dr. Jessa advises the anticipated duration of these injuries as 9-12 weeks.

8The applicant developed some pain in the days following the accident and attended at the offices of Dr. G. Dhillon on July 24, 2019, with complaints of neck and shoulder pain and spine pain upon rotation. ² The applicant advised Dr. Dhillon that he had been attending physiotherapy but had noticed minimal improvement.

9Dr. Dhillon diagnosed the applicant with soft tissue injuries and whiplash and prescribed medications to relieve the applicant’s pain. Dr. Dhillon noted that the applicant’s neurological examination was normal. Dr. Dhillon advised the applicant to continue physical rehabilitation and re-attend if needed.³

10The applicant re-attended at the offices of Dr. Dhillon on March 4, 2020.⁴ At this time the applicant complained of upper back and neck pain since the subject accident. Dr. Dhillon also noted “also has headache”.

11At this time Dr. Dhillon diagnosed the applicant with cervical myofascial strain and prescribed the same medications to relieve pain.

12On July 21, 2020, the applicant participated in a virtual appointment with Dr. Dhillon and had his prescriptions refilled as these provided relief for the applicant’s neck and back pain.

13This was the applicant’s third and final accident-related visit with Dr. Dhillon after the subject accident and prior to the applicant’s appeal to the Tribunal.

14On March 3, 2020, the applicant participated in an Insurer’s Examination (“IE”) conducted by Dr. Todd Walters. Dr. Walters’ report in relation to this examination is dated March 9, 2020.⁵ Dr. Walters states his credentials in his report. Dr. Walters is a licensed medical practitioner in Ontario. He is a Certificant and Fellow of the Canadian College of Family Practitioners and holds a second Fellowship from the American Academy of Disability Evaluating Physicians. At the time of his report, Dr. Walters was also a non-economic loss assessor for the Workplace Safety & Insurance Board of Ontario, a designated physician for the Royal Canadian Mounted Police, and a panel physician for the Immigration and Naturalization Services of the United States of America. This was an in-person examination in which Dr. Walters reviewed several documents, made observations of the applicant, and conducted an interview of the applicant.

15Dr. Walters concluded at this time that the applicant sustained injuries consistent with the definition of minor injury as found in the Schedule and that there were no limitations or restrictions that would prevent the applicant from achieving maximal recovery.⁶

16Dr. Walters diagnosed the applicant with cervical strain and lumbar strain without musculoskeletal impairment.⁷

17Dr. Walters concluded that he claimant’s injuries meet the criteria of a minor injury as defined in the Schedule.⁸

18Based on the totality of the evidence before me, I find that the applicant suffered injuries that were minor as defined by the Schedule as a result of the subject accident. Dr. Jessa who examined the applicant on May 25, 2019, described the applicant’s injuries as sprains and strains. Dr. Dhillon, the applicant’s family physician, examined the applicant in July 2019, and diagnosed the applicant with soft tissue injury and whiplash. These findings were then corroborated by the IE assessors, Dr. Walters, and Dr. Marino.

19These health care practitioners all made initial examinations of the applicant within a one-year time-period from the subject accident. These examinations were conducted as in-person examinations and assessments. This gave these assessors opportunity to make observations of the applicant as well as to conduct a medical history interview of the applicant.

Did the Applicant Have a Pre-existing Condition?

20Section 18(2) of the Schedule provides that insured persons with minor injuries who have a pre-existing medical condition may be exempt from the $3,500.00 cap on benefits. To be removed from the MIG, the applicant must provide compelling evidence meeting the following requirements:

1. There was a pre-existing medical condition that was documented by a health practitioner before the accident; and
2. The pre-existing condition will prevent maximal recovery from the minor injury if the person is subject to the $3,500.00 limit on treatment costs under the MIG.

21The standard for excluding an impairment on the basis of pre-existing condition(s) is well-defined and strict. A pre-existing condition will not automatically exclude a person’s impairment from the MIG.

22The applicant did not provide submissions as to whether he had any pre-existing conditions that would remove him from the MIG. The respondent submitted that the applicant has repeatedly denied any significant past medical or surgical history.

23The applicant’s self-reporting to both section 25 and section 44 IE assessors is consistent throughout the evidence submitted by the applicant and respondent with regards to the applicant’s pre-accident health. The applicant has not undergone any pre-accident surgeries, that he has not suffered any pre-accident fractures and that he has not been involved in any previous motor vehicle accidents. Further, the applicant advised all the assessors he does not suffer any pre-existing medical condition, did not suffer any chronic pain, headaches, or psychological issues prior to the subject accident.⁹

24Based on the totality of the evidence before me, I do not find that the applicant has a pre-existing condition that would remove him from the MIG.

Did the Applicant Sustain a Psychological impairment?

25A psychological impairment, if established, may fall outside the MIG, because the MIG only governs “minor injuries”, and the prescribed definition does not include accident-related psychological impairments.

26The applicant submitted that he “suffers from substantial injuries, both physical and psychological.”¹⁰

27The applicant made three visits to his family physician, Dr. Dhillon after the subject motor vehicle accident. The clinical notes and records of Dr. Dhillon do not contain any complaints from the applicant, or observations by Dr. Dhillon, of any psychological impairment.

28The applicant relies upon the examination conducted by pain specialist, Dr. G. Karmy. He was examined via videoconference by Dr. Karmy. The report of Dr. Karmy is dated April 19, 2021, but the date of the examination is unclear. The report states the date of examination as March 27, 2019, but this predates the subject accident by approximately six weeks. In his report, Dr. Karmy references reviewing an OHIP summary of the applicant covering a period from May 11, 2013, to August 11, 2020, I therefore assume the examination by Dr. Karmy was conducted sometime between August 11, 2020, and April 19, 2021.

29The report of Dr. Karmy, who assessed the applicant for chronic pain concludes that the applicant “suffered substantial psychological distress” resulting from the subject accident¹¹. Dr. Karmy diagnosed the applicant with Chronic Pain Syndrome.¹²

30In his conclusions, Dr. Karmy describes Chronic Pain Syndrome as “the combination of chronic pain and secondary psychological complications that further increase the original pain”.¹³

31On February 13, 2020, the applicant underwent a section 44 IE assessment by Dr. A. Marino, a registered psychologist. This was an in-person examination, in which Dr. Marino completed a document review and subjected the applicant to the following psychometric testing to complete the psychological assessment of the applicant:

1. Clinical Interview
2. Structured Inventory of Malingered Symptomology (“SIMS”)
3. Beck Depression Inventory – II (“BDI-II”)
4. Beck Anxiety Inventory (“BAI”)
5. Pain Patient Profile (“P3”)
6. Personality Assessment Screener (“PAS”)

32In his report Dr. Marino stated that the applicant reported that he had not participated in any psychotherapy or counselling after the subject accident. The applicant reported to Dr. Marino that he did have a conversation with someone at his physiotherapy clinic about mental health. The applicant further reported to Dr. Marino that he did not request any psychological intervention at all but instead, was encouraged to do so by the healthcare provider he spoke with at the physiotherapy clinic. The applicant reported to Dr. Marino that he was not interested in participating in any psychotherapy.¹⁴

33I place significant weight upon this information that the applicant provided to Dr. Marino during his clinical interview. This suggests that the applicant does not feel that the subject accident had an impact on his psychological health. This is corroborated by Dr. Marino’s conclusions.

34Dr. Marino concluded that after administering the psychometric testing that the applicant was being “honest and forthright” during the testing and that the test results could be “interpreted with confidence”.¹⁵

35Dr. Marino’s testing found that the applicant scored in the minimal range for depressive symptomology, in the minimal range for anxious symptomology on the BDI-II and BAI respectively.¹⁶

36In relation to the P3, Dr. Marino found that the applicant produced a valid score. He further stated that the applicant scored in the average range for depression, anxiety, and somatic complaints in comparison to other pain patients. Dr. Marino that patients such as this tend to believe their pain is serious but generally do not obsess over the pain.¹⁷

37In relation to the PAS, Dr. Marino found that the applicant produced a valid profile. Dr. Marino further found that his total score was in the normal range. No scale was in the marked range, and all were mild to normal, but one, for the ten clinical problem domains of negative affect, hostile control, acting out, suicidal thinking, health problems, alienation, psychotic features, alcohol problem, social withdrawal, and anger control. The exception was health problems which measured moderate.¹⁸

38Dr. Marino concluded that the applicant,” does not present with any significant psychological impairment or diagnosis.”¹⁹

39After reviewing the submissions and evidence I conclude that the applicant did not suffer any significant psychological impairment as a result of the subject accident.

40The applicant’s family physician, Dr. Dhillon, made no observations of the applicant and noted no complaints from the applicant of any significant psychological impact as a result of the subject accident.

41Dr. Karmy was reliant upon the self-reporting of the applicant with regards to making conclusions about the applicant’s psychological health because he had a limited scope of observation of the applicant due to the virtual examination format. From Dr. Karmy’s report, it appears that the applicant did not undergo any psychometric testing during this examination.

42Dr. Karmy is a pain specialist and presented as having expertise in Chronic Pain Syndrome diagnosis and treatment. Dr. Karmy defines Chronic Pain Syndrome as having a psychological impact on persons living with this condition. I assign little weight this ability or expertise in diagnosing psychological impairments as this is outside his area of expertise. In his report Dr Karmy states his credentials as a chronic pain specialist but makes no indication of any training, certification, designation, or expertise in diagnosing and treating psychological impairments.²⁰

43In contrast, Dr. Marino is a certified psychologist. Dr. Marino examined the applicant in person and administered a series of objective psychological tests to determine the impact, if any, that the subject accident had on the psychological health of the applicant. I conclude that Dr. Marino’s examination of the applicant was the most thorough examination that the applicant underwent in relation to determining if the applicant suffered any psychological impairment which may have been caused by the accident.

44Given the totality of the evidence, I conclude that the subject accident did not cause the applicant to suffer a significant psychological impairment.

Did the Subject Accident Cause the Applicant Chronic Pain or Chronic Pain Syndrome?

45The Tribunal has found that chronic pain syndrome would remove an injured person from the MIG, as this diagnosis is not included in the definition of “minor injury” in s. 3(1) of the Schedule.

46Despite the applicant submitting that he has Chronic Pain Syndrome, he only made three post-accident visits to Dr. Dhillon, his family doctor. The last of these in July 2020. In these visits he did complain of pain, but Dr. Dhillon did not of the three visits.

47The applicant submits that he is living with Chronic Pain Syndrome and relies upon the diagnosis of Chronic Pain Syndrome based primarily upon the examination and report of Dr. Karmy dated April 19, 2021.

48Dr. Karmy made the following diagnoses:

1. Chronic Post-Traumatic Headache, caused by the subject accident.
2. Persisting symptoms following mild Traumatic Brain Injury, caused by the subject accident.
3. Chronic mechanical neck pain, likely originating from the cervical discs and facet joints, caused by the subject accident.
4. Chronic mechanical upper back pain, likely originating from the thoracic discs and facet joints, caused by the subject accident.
5. Chronic mechanical lower back pain, likely originating from the lumbar discs and facet joints, caused by the subject accident.
6. Chronic Pain Syndrome, caused by the subject accident.
7. Sleep disorder, related to the subject accident.
8. Possible mood disorder, caused by the subject accident²¹

49The applicant submits that he “immediately started suffering severe headaches” after the subject accident.²² Based solely on the applicant’s self-reporting, Dr. Karmy diagnosed the applicant with Chronic post-Traumatic headache and mild Traumatic Brain Injury. These diagnoses made in the absence of an in-person examination, without any supporting diagnostic testing or imaging and no explanation of evidence which led to these diagnoses beyond the applicant’s self-reporting.

50Dr. Karmy did conduct a document review as part of the examination and used this information to generate the report of April 19, 2021. However, headaches do not appear to be a prominent applicant complaint in the clinical notes and records of Dr. Dhillon. The July 24, 2019, visit does not document a complaint of headache, and Dr. Dhillon notes that the neurological exam was normal. The visit of March 4, 2020 mentions headache in passing, with the notation “also has headache” with no reference to frequency, severity, duration, or any other qualifiers.²³ Dr. Dhillon’s notes from the virtual visit of July 21, 2020 makes no mention of headache.

51From these three post-accident visits with the applicant’s G.P. it seems that there is no evidence to suggest that he “immediately started suffering severe headaches.”²⁴ Dr. Dhillon does not note any signs or symptoms of a traumatic brain injury and no further neurological examinations are recommended by Dr. Dhillon.

52The OCF-3 completed by Dr. Jessa of Complete Rehab Centre on May 25, 2019, which is two weeks post-accident makes no mention of severe headache. On the OCF-18 of October 11, 2019, Dr. Jessa does note “sharp headaches are reported which occur intermittently” but does not list severe headache in the Injury Information and Sequelae section.²⁵ The OCF-18 of January 28, 2020, also does not list severe headache at all as a complaint.

53The IE assessors, Dr. Walters, and Dr. Marino do not mention in their respective reports that the applicant provided any information about suffering from “severe headaches” immediately following the subject accident. The applicant did advise Dr. Marino that he has experienced headaches at a rate of one to two times per week since the subject accident. This is consistent with the information noted by Dr. Dhillon and Dr. Jessa. Dr. Walters and Dr. Marino made no comments with regards to persisting signs or symptoms of a traumatic brain injury.

54Dr. Karmy’s diagnoses of chronic mechanical neck pain, chronic mechanical upper back pain, and chronic mechanical lower back pain differ from the findings of Dr. Dhillon and Dr. Walters who both conducted in-person examinations of the applicant. Again, Dr. Karmy did not conduct an in-person physical examination, did not conduct any diagnostic imaging, and relied almost entirely upon the applicant’s self-reporting.

55The applicant, in their submissions, cites Y.X.Y.and the Personal Insurance Company (16-000438), and quotes Adjudicator Nielson. In this case Adjudicator Nielson stated, “when chronic pain causes functional impairment and disability, it takes one out of the MIG.” Adjudicator Neilson continued, “I also agree with the reasoning in Arruda and Western Assurance Company that it is not ongoing pai alone that takes an applicant out of the MIG, but rather chronic pain syndrome. In both cases the applicants’ pain affected their functional abilities to engage in, for example, their employment, and housekeeping or caregiving activities. The point common to both decisions is that ongoing pain alone is insufficient to take one out of the MIG. Rather, than ongoing pain must be accompanied by some functional impairment.”²⁶

56I agree with this analysis that pain alone may not remove a person from the MIG, but pain accompanied with functional impairment or disability is much more compelling evidence that could lead to a removal from the MIG.

57Dr. Karmy does state, in his report, that he is of the opinion that the applicant does suffer accident-related functional limitations that interfere with the applicant’s ability to carry out his pre-accident job-related activities and housekeeping duties.²⁷

58Dr. Karmy, however does not provide an explanation of how these injuries are impacting the applicant’s attempts to perform these activities.

59The respondent argues in their submissions that the applicant’s accident-related functional limitations are not assessed by Dr. Karmy using the American Medical Association (AMA) Guides to determine if chronic pain results in functional impairment. In its submissions, the respondent cites Tribunal decision 17-007825 Applicant v Aviva²⁸ which stated an applicant’s chronic pain should be assessed using the AMA Guides as consideration for removal of an applicant from the MIG based on chronic pain in combination with functional impairment. These AMA Guide criteria are:

a) Use of prescription drugs beyond the recommended duration and/or abuse of or dependence on prescription drugs or other substances

b) Excessive dependence on health care providers, spouse, or family

c) Secondary physical deconditioning due to disuse and or fear-avoidance of physical activity due to pain

d) Withdrawal from social milieu, including work, recreation, or other social contacts

e) Failure to restore pre-injury function after a period of disability, such that the physical capacity is insufficient to pursue work, family, or recreational needs; Development of psychosocial sequelae after the initial incident, including anxiety, fear-avoidance, depression, or nonorganic illness behaviors.

60In this case before me, the applicant has not provided evidence to support that his chronic pain in combination with functional impairments meets the threshold of any of the AMA Guide criteria that could lead to his removal from the MIG.

61The applicant, in speaking with all healthcare providers advised that he returned to his job as a truck driver shortly after the subject accident. Dr. Jessa notes in the OCF-3 of May 25, 2019, two weeks post-accident, that the applicant had returned to working but “he modifies his tasks to accomplish his duties”.²⁹

62The OCF-18 of October 11, 2019, completed by Dr. Jessa states that the applicant is “working despite his pain due to financial responsibilities.”

63The OCF-18 of January 28, 2020, completed by Dr. Jessa states that the applicant “reports that he is working despite his pain.”

64The applicant’s evidence is that he saw Dr. Dhillon for the first time, post-accident on July 24, 2019. Nowhere in Dr. Dhillon’s clinical notes and records is there any discussion between the applicant and his Dr. Dhillon regarding his inability to work or with a requirement for modifications or accommodations. Nor are there work-related discussions between the applicant and Dr. Dhillon in the clinical notes and records of the other two post-accident visits the applicant had with Dr. Dhillon.

65Dr. Marino, assessed the applicant on February 13, 2020, and noted

1. He (the applicant) reported that he performed “shorter, four or five-hour trips” for two weeks, then subsequently returned to his pre-accident hours and responsibilities.³⁰

66Dr. Walters assessed the applicant on March 3, 2020 and noted that the applicant reported working less in the four to six weeks after the accident due back pain which had increased in the two-weeks following the accident. Dr. Walters noted the applicant was seen by his family doctor at about one month following the accident when he was prescribed medication.³¹

67Dr. Walters then goes on to note that the applicant had returned to “full-time regular duties” after a couple months post- accident. This information is a self-report of the applicant. Further in his report, Dr. Walters notes that the applicant did report low back pain after three or four hours of straight driving but gets some relief by adjusting his position.³²

68Dr. Karmy’s report of April 19, 2021, which stated, again from the applicant’s self-reporting, that the applicant returned to work a couple days after the accident. The applicant complained to Dr. Karmy that he has pain throughout his working day which is exacerbated by sitting in the driver seat for long hours. Dr. Karmy further noted that the applicant experienced neck pain while driving also. Dr. Karmy noted that the applicant reported that he worked fewer hours and lost income because of these difficulties.³³

69I find the comments made with regards to pain during work to be consistent with the reports of the other healthcare practitioners submitted into evidence. However, the notation that he worked fewer hours then previously seems to be inconsistent as the other healthcare practitioners make notations in their respective reports that indicate the applicant had returned to his pre-accident duties and hours.

70Based on the evidence submitted, I am satisfied that the applicant returned to his regular work duties and hours without modification or accommodation within a few months of the subject accident. At each report, the applicant does state, and the assessors recognize that there is pain associated with his regular work duties as a long-distance truck driver. He reports however, that he mitigates this pain through a combination of prescription and over the counter medications, adjusting position, and stretching.

71Dr. Walters was able to observe the applicant in person during his examination and ask the applicant to perform a small battery of physical tests. Dr. Walters noted in his report that the applicant entered the examination walking normally and was able to sit upright in a chair for 30 minutes without adjusting his position. Dr. Walters observed that the applicant rose from the chair and stood independently. Dr. Walters noted the applicant had full range of motion through his back and shoulders, he could stand on his toes, and on one foot and that he performed a full squat.³⁴

72Dr. Walters did not note any functional impairment throughout the series of movements undertaken by the applicant as part of the examination.

73Dr. Marino, who conducted an interview of the applicant during the examination asked about the applicant’s ability to perform his activities of daily living. Dr. Marino noted that the applicant can perform childcare tasks the same way before and after the subject accident. Dr. Marino noted that the applicant performs household chores after the accident including yard work although the applicant has family help with heavier tasks. The applicant reported to Dr. Marino that he continues to socialize with friends and is able to do personal care without assistance, as he could before the subject accident.³⁵

74This self-reported evidence indicates that the applicant has little to no functional impairment due to pain caused by the subject accident.

75Dr. Dhillon does note any observations of functional impairment, no difficulties with movement other than some associated pains. Dr. Dhillon does not note any observed difficulties of movement of the applicant as the applicant entered or moved within the examinations and does not note any complaints of limitations from the applicant other than pains, as all the assessors have noted.

76In reviewing the evidence submitted in this matter I am persuaded by the in-person observations, testing and self-reports found in the clinical notes and records of Dr. Dhillon, and the reports of Dr. Walters and Dr. Marino. In direct contrast to the self-reported, virtual examination-based evidence in the report submitted by Dr. Karmy.

77I find based on the evidence submitted that the applicant does have ongoing pain, but it does not cause a functional ability or impairment that would remove him from the treatment limits of the MIG.

78I find that the evidence submitted does not support that the applicant suffered injuries beyond sprain, strain, whiplash associated disorder, contusion, abrasion, laceration, or subluxation and includes any clinically associated sequelae to such an injury and includes any clinically associated sequelae to such an injury.

79I further find that the applicant has not demonstrated that he suffered from a pre-existing condition that would limit their recovery.

80I also find that the applicant did not suffer a psychological impairment as a result of the subject accident.

81I also find that the applicant did not demonstrate that they suffer chronic pain or a chronic pain syndrome that would remove them from the limitations of the Minor Injury Guideline.

82Therefore, I find that the applicant has not met their burden of demonstrating on a balance of probabilities that he suffered injuries that were beyond the severity of pre-dominantly minor as defined in s. 3 of the Schedule and therefore subject to treatment within the $3,500.00 limit and in the MIG.

83As I do find that the applicant’s injuries are pre-dominantly minor, and that the MIG limits for medical benefits, to which the applicant is entitled have been exhausted³⁶, I do not find it necessary to consider the reasonableness and necessity of the disputed treatment plans.

84As there is no entitlement to the medical benefits in the disputed treatment plans there is no entitlement to the interest pursuant to s. 51 of the Schedule.

ORDER

85For the reasons listed above I find:

1. The applicant sustained predominantly minor injuries.
2. The applicant is not entitled to the treatment plans claimed in the application.
3. The applicant is not entitled to interest.
4. The application is dismissed in its entirety.

Footnotes

1. 1Found at Tab E of the applicant’s submissions
2. 2The clinical notes and records of Dr. Dhillon are found at Tab B of the applicant’s submissions
3. 3The clinical note and record of the applicant’s July 24, 2019, visit to Dr. Dhillon is found at a page titled 05/13 of Tab B of the applicant’s submissions
4. 4The clinical note and record of the applicant’s March 4, 2020, visit to Dr. Dhillon is found at a page tilted 06/13 of Tab B of the applicant’s submissions
5. 5Dr. Walters’ report is found at page 15, Tab 1 of the respondent’s submissions.
6. 6Dr. Walters’ conclusions found at page 19, Tab 1 of the respondent’s submissions.
7. 7Dr. Walters’ diagnosis found at page 19, Tab 1 of the respondent’s submissions.
8. 8Dr. Walters’ conclusions found at page 19, Tab 1 of the respondent’s submissions
9. 9The clinical notes and records of Dr. Dhillon, the report of Dr. Walters and the report of Dr. Marino.
10. 10Page 9 paragraph 23 of the applicant’s written submissions.
11. 11Page 8 of the report authored by Dr. Karmy located at Tab H of the applicant’s submissions.
12. 12Page 6 of the report authored by Dr. Karmy located at Tab H of the applicant’s submissions
13. 13Page 8 of the report authored by Dr. Karmy located at Tab H of the applicant’s submissions.
14. 14Page 27 of Tab 2 of the respondent’s submissions (page 5 of Dr. Marino’s report)
15. 15Page 30 of Tab 2 of the respondent’s submissions (page 8 of Dr. Marino’s report)
16. 16Page 30 of Tab 2 of the respondent’s submissions (page 8 of Dr. Marino’s report)
17. 17Page 30 of Tab 2 of the respondent’s submissions (page 8 of Dr. Marino’s report)
18. 18Page 31 of Tab 2 of the respondent’s submissions (page 9 of Dr. Marino’s report)
19. 19Page 31 of Tab 2 of the respondent’s submissions (page 9 of Dr. Marino’s report
20. 20Page 2 of Tab H of the applicant’s submissions
21. 21Page 5-6 of the report authored by Dr. Karmy located at Tab H of the applicant’s submissions.
22. 22Page 1 of the applicant’s submissions (“Injuries Suffered As A Result of The Subject Accident” paragraph 1)
23. 23Page titled 6 of 13 of Tab B of the applicant’s submissions
24. 24Page 1 of the applicant’s submissions (“Injuries Suffered As A Result of The Subject Accident” paragraph 1)
25. 25Found at Tab F of the applicant’s submissions
26. 26Page 5 of the applicant’s submissions
27. 27Page 5 of Tab H of the applicant’s submissions.
28. 28Page 8 of the respondent’s submissions and page 42 of the respondent’s book of authorities
29. 29Found at Tab E of the applicant’s submissions
30. 30Page 26 of Tab 2 of respondent’s submissions (page 4 of Dr. Marino’s report)
31. 31Page 17 of Tab 1 of the respondent’s submissions (page 3 of Dr. Walters’ report)
32. 32Page 18 of Tab 1 of the respondent’s submissions (page 4 of Dr. Walters’ report)
33. 33Page 4 of Dr. Karmy’s report at Tab H of the applicant’s submissions
34. 34Page 18 of Tab 1 of the respondent’s submissions (page 4 of Dr. Walters’ report)
35. 35Page 28 of Tab 2 of the respondent’s submissions (page 6 of Dr. Marino’s report)
36. 36Paragraph 10 of Schedule A of the respondent’s Case Conference Summary indicates benefits have been exhausted