Category: Minor Injury Guideline

The claimant sought a determination that his impairments were outside of the MIG and entitlement to one treatment plan for a psychological assessment. Adjudicator Sewrattan found that the claimant’s injuries were predominantly minor and that his entitlement was subject to the MIG. In terms of psychological impairments, the adjudicator found that the diagnosis of mixed anxiety and depressive disorder made during the psychological assessment was too far removed from the test results produced. In terms of physical injuries, the adjudicator noted that the claimant’s submission that he suffered from chronic pain was based on a single clinical note from his new family doctor, with no explanation for the diagnosis. The Adjudicator concluded that the claimant was entitled to payment for the psychological assessment only if funds remained within the MIG.

The claimant sought removal from the MIG and entitlement to five treatment plans. Adjudicator Hines found that the claimant did not submit sufficient evidence to support that he suffered a non-minor injury. She also held that the claimant did not adduce evidence explaining why Type 2 Diabetes or Hepatitis B would prevent the claimant from achieving maximum medical recovery under the MIG.

The claimant sought removal from the MIG and two medical benefits. Adjudicator Mather concluded that the claimant had not submitted sufficient evidence of a non-minor injury, or sufficient evidence of a pre-existing condition. The claims were dismissed.

The claimant sought entitlement to five treatment and assessment plans. The insurer denied the treatment based on a MIG determination. Adjudicator Johal dismissed all claims and upheld the MIG determination. Of note, while Adjudicator Johal found the claimant did suffer from issues of anxiety, depression, sleeping problems, and panic attacks prior to the accident, it was noted that “the presence of pre-existing conditions alone is not sufficient to remove the applicant from the MIG. The applicant bears the onus and must adduce evidence to demonstrate that the pre-existing condition prevents him from achieving maximal recovery within the MIG.”

The claimant sought entitlement to physiotherapy and an FAE. The insurer denied the treatment based on a MIG determination. Adjudicator Anwar considered the medical evidence submitted, including family doctor clinical notes and records, and determined the claimant did not prove entitlement to treatment beyond the MIG.