Category: Minor Injury Guideline

The claimant sought removal from the MIG, entitlement to medical benefits, and interest. The claimant argued that pre-existing back degenerative changes, in conjunction with his alleged chronic pain, warranted treatment outside of the MIG. The claimant further claimed that he had incurred significant treatment expenses to enable him to return to employment, and relied on s.57(2) of the SABS to argue that the insurer was responsible for those costs. Adjudicator Ferguson disagreed, finding that there was no connection between a prescribed duty to mitigate medical issues and an obligation by the insurer to pay for treatment of those issues. Adjudicator Ferguson held that the claimant’s injuries fell within the MIG, and denied the disputed treatment plans and interest claimed.

The claimant sought a determination that his impairments were outside of the MIG and entitlement to benefits proposed in five treatment plans. Adjudicator Lake found that the claimant’s injuries fell within the MIG and that the treatment plans in dispute were not payable as the MIG limits had been exhausted.

The claimant sought a determination that his impairments were outside of the MIG as well as entitlement to medical benefits proposed in one treatment plan. The claimant argued that he should be removed from the MIG due to chronic pain. The parties agreed that chronic pain as a result of the accident may remove a claimant from the MIG. Adjudicator Ferguson found that the section 25 orthopaedic report was of limited persuasive value because it was performed three years after the accident and failed to discuss subsequent injuries in the applicant’s medical history that might raise questions about causation. Adjudicator Ferguson found that claimant was within the MIG and dismissed the application.

The claimant sought a determination that his impairments were outside of the MIG as well as entitlement to medical benefits proposed in three treatment plans. The claimant argued that he should be removed from the MIG due to chronic pain and pre-existing injuries from a previous motor vehicle accident. Adjudicator Maleki-Yazdi held that for chronic pain to fall outside of the MIG, the claimant must be suffering from severe, persistent, and constant pain, and that the pain must cause the claimant to have a functional impairment adversely affecting his activities of daily living. The adjudicator found that the claimant did not have pain that caused a functional impairment or that was severe and constant. Adjudicator Maleki-Yazdi found that claimant was within the MIG and dismissed the application.

The claimant sought a determination that her impairments were outside of the MIG as well as entitlement to medical benefits proposed in six treatment plans. The claimant argued that she should be removed from the MIG due to accident-related psychological impairments and chronic pain. Adjudicator Maleki-Yazdi held that for chronic pain to fall outside of the MIG, the claimant must be suffering from severe, persistent, and constant pain, and that the pain must cause the claimant to have a functional impairment adversely affecting her activities of daily living. The adjudicator found that the claimant did not have a psychological injury and did not meet the onus to prove she suffered from chronic pain as a result of the accident. Adjudicator Maleki-Yazdi found that claimant was within the MIG and dismissed the application.

The claimant sought removal from the MIG and entitlement to various treatment plans. Adjudicator Mazerolle denied the claims. He held that the claimant failed to explain why the alleged pre-existing conditions would prevent recovery under the MIG, and that she failed to explain why the claimant’s pain was not sequelae of a minor injury.

The insurer denied a treatment plan for chiropractic treatment and the cost of an examination based on its finding that the claimant’s injuries fell within the MIG. The claimant disputed the insurer’s denials. Adjudicator Driesel found that the claimant’s injuries fell within the MIG. Specifically, Adjudicator Driesel rejected the claimant’s assertion that pre-existing conditions precluded her from recovering within the MIG due to lack of evidence that her pre-existing back pain was extreme or continual or that she had a pre-existing mental or psychological conditions.

The claimant sought a determination that his impairments were outside of the MIG as well as entitlement to medical benefits proposed in ten treatment plans. The claimant argued that he should be removed from the MIG due to chronic pain. When assessing the claim of chronic pain, Adjudicator Ferguson applied the following criteria: i) Does the claimant suffer constant pain – more than simple ongoing or recurrent, intermittent pain? ii) Has the claimant’s pain persisted beyond the normal healing times for the injuries sustained? iii) Is the pain a clinically associated sequelae to minor injuries? iv) Does the claimant’s pain cause functional impairment and disability? Does it significantly disrupt or disable pre-accident activities of daily living? Adjudicator Ferguson found that the claimant failed to meet the onus to prove that he should be removed from the MIG on chronic pain grounds because i) the intermittent pain described in the medical records did not appear to meet the threshold of constant, severe pain; and ii) on balance, he did not find that the evidence illustrated that the claimant’s pain had significantly disrupted or disabled his pre-accident activities. Adjudicator Ferguson found that claimant was within the MIG and dismissed the application.