D.0. v. Primmum Insurance Company (18-001673)

The claimant sought a determination that his impairments were outside of the MIG and entitlement to two treatment plans for physiotherapy. The claimant submitted that the he developed chronic pain as a result of the accident. In support of his position, he relied on three OCF-3s, a s. 25 chronic pain report, and family doctor records. The insurer relied on a s. 44 physiatry report and argued that the claimant was not diagnosed with chronic pain syndrome and had not been referred to a chronic pain specialist. Adjudicator Hans found that the claimant’s physical impairments were outside of the MIG as a result of chronic pain and that the disputed benefits were reasonable and necessary. Adjudicator Hans held that a diagnosis of chronic pain syndrome was not required to remove a claimant from the MIG.