1Amineeta Harricharan, the applicant, was involved in an automobile accident on September 22, 2019, and sought benefits pursuant to the Statutory Accident Benefits Schedule - Effective September 1, 2010 (including amendments effective June 1, 2016) (the “Schedule”). The applicant was denied benefits by the respondent, Aviva Insurance Company of Canada, and applied to the Licence Appeal Tribunal - Automobile Accident Benefits Service (the “Tribunal”) for resolution of the dispute.

ISSUES

2The issues in dispute are:

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 Minor Injury Guideline limit?
2. Is the applicant entitled to $2,200.00 for an OT in-home assessment, proposed by Innovative Occupational Therapy Services in a treatment plan/OCF-18 (“plan”) dated March 2, 2023?
3. Is the applicant entitled to $6,033.60 for occupational therapy services, proposed by Innovative Occupational Therapy Services in an OCF-18 dated March 2, 2023?
4. Is the applicant entitled to an income replacement benefit (“IRB”) in the amount of $400.00 per week from October 4, 2020 to date?
5. Is the applicant entitled to interest on any overdue payment of benefits?
6. Is the respondent liable to pay an award under s. 10 of Reg. 664 because it unreasonably withheld or delayed payments to the applicant?

RESULT

3The applicant has not established that her impairments arising from the accident fall outside the MIG. Further, she has not proven entitlement to any of the disputed benefits.

ANALYSIS

The applicant’s impairments fit within the MIG

4Section 18(1) of the Schedule sets out that medical and rehabilitation benefits are limited to $3,500.00 if the insured person sustains an impairment that is predominantly minor in accordance with the MIG. Section 3(1) 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.”

5An insured person may successfully be removed from the MIG if they can establish that their accident-related injuries fall outside of the MIG or, pursuant to s. 18(2), that they have a documented pre-existing injury or condition combined with compelling medical evidence stating that the condition prevents recovery if they are kept within the MIG. The Tribunal has also determined that chronic pain with functional impairment or a diagnosed psychological condition may justify removal from the MIG. The applicant bears