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S.L. v. Aviva Insurance Company (19-00278)

  • March 2, 2020

The claimant sought entitlement to IRBs, removal from the MIG, and entitlement to medical benefits proposed in eight treatment plans. Adjudicator Lester found that the claimant’s injuries fell with the MIG and that none of the treatment plans in dispute were payable as the MIG limits had been exhausted. However, the claimant was deemed entitled to IRBs up to when he returned to work, with interest. The claimant argued that he was suffered from a chronic pain disorder. However, the adjudicator noted that the claimant did not prove that he was experiencing a “significant and reliable impairment of functional status or that he showed a severe debilitating condition of ongoing pain”. With that said, Adjudicator Lester noted that on the balance of probabilities, it was reasonable to conclude that someone who was diagnosed with strains and sprains would need some time off from a very heavy physically demanding job in order to heal the injuries.

Full decision here

TGP Analysis

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  • FILED UNDER Income Replacement Benefits, Minor Injury Guideline
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