Category: Minor Injury Guideline

P.S. v. Wawanesa Mutual Insurance Company (011156)

The claimant sought removal from the MIG and entitlement to two treatment plans. Adjudicator Victor held that the claimant’s injuries fell within the MIG. The evidence supported that the claimant suffered soft tissue injuries, and did not support a pre-existing shoulder injury that would prevent maximal recovery under the MIG.

O.S. v. Travelers Insurance (18-003385)

The claimant sought reconsideration of the Tribunal’s decision to keep the claimant in the MIG and dismissing the claims for three medical benefits. Adjudicator Watt dismissed the reconsideration request. He held that none of the grounds of Rule 18.2 were satisfied. The Tribunal had considered all the evidence and weighed the evidence as it felt appropriate. He noted that a diagnosis of chronic pain did not automatically remove an insured from the MIG.

B.C. v. Aviva Insurance Company (17-007448)

The claimant sought reconsideration of the Tribunal’s refusal to remove him from the MIG. Adjudicator Norris rejected the reconsideration request. He wrote that the Tribunal had not failed to consider the OCF-3s, and had not overlooked diagnoses alleged by the claimant. Rather, the Tribunal had weighed the evidence differently and did not accept the claimants submissions. There was no error in law. He also dismissed the arguments relating to section 38(8) because it was a new argument and not before the Tribunal at the hearing.

S.K. v. Aviva Insurance Canada (18-003544)

The claimant sought reconsideration of the Tribunal’s refusal to remove her from the MIG. Adjudicator Lake rejected the reconsideration request, holding that claimant’s arguments were an attempt to reargue the case and to reweigh the evidence.

M.S. v. Dominion of Canada General Insurance (19-000579)

The claimant sought removal from the MIG and entitlement to six medical benefits. Adjudicator Norris held that the MIG applied to the claimant’s injuries. There was no evidence that the claimant’s pre-existing medical issues would impact his recovery under the MIG. He also held that the alleged psychological injuries and chronic pain were not outside of the “minor injury” definition.

A.D. v. Certas Home and Auto Insurance (18-006204)

The claimant disputed his MIG determination and sought entitlement to a number of treatment plans for physical and psychological treatment. The claimant submitted no clinical notes and records, and there was no evidence to support that he was ever seen by a medical doctor for his accident-related impairments. Given the lack of evidence to demonstrate that the claimant was unable to recover within the MIG, Adjudicator Grant concluded that the claimant had failed to meet his onus of establishing entitlement to treatment outside of the MIG limits.

C.S. v. Wawanesa Mutual Insurance Company (18-004665)

The claimant sought a determination that his impairments were outside of the MIG and entitlement to treatment plans for psychological services and chiropractic treatment. Adjudicator Grant found that the claimant suffered from chronic pain, which removed him from the MIG. He was not entitled to the two treatment plans in dispute, which were found to be not reasonable and necessary as a result of the accident. The treatment plans in dispute were not supported by any medical evidence or recommendation from the treating physician. Subjective reports of some relief from previous physiotherapy did not establish that the in-dispute chiropractic treatment plan was reasonable and necessary. A psychological pre-screening report was not sufficient evidence to indicate the existence of a psychological impairment that was not sequelae of minor injuries.

T.S.W. v. The Dominion of Canada General Insurance Company (18-010342)

The claimant sought a determination that his impairments were outside of the MIG and entitlement to NEBs, the cost of prescription medication, and one treatment plan. Adjudicator Driesel found that the claimant was within the MIG and was not entitled to the disputed benefits.

C.G. v. Aviva Insurance (18-008957)

The claimant sought removal from the MIG and entitlement to an attendant care assessment and assistive devices. Adjudicator Grant dismissed the claims. He held that the claimant’s physical and psychological injuries met the definition of “minor injury”. He also rejected the argument that the claimant suffered chronic pain as a result of the accident.

G.A. v. The Personal Insurance Company (18-003420)

The claimant sought removal from the MIG and entitlement to various medical benefits. Adjudicator Watt held that the claimant’s injuries fell within the MIG. He rejected the opinion of the claimant’s neurologist because it was not based on accurate facts.