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A.G. v. Coseco Insurance (18-007969)

  • January 9, 2020

The claimant sought removal from the MIG, entitlement to a chronic pain assessment and chronic pain program, and interest on the payment of overdue benefits. Adjudicator Sharda found that the claimant should be removed from the MIG since the chronic pain she suffered in her neck and left shoulder were not predominantly minor injuries. Adjudicator Sharda further found compelling evidence of the claimant’s pre-existing medical condition; her chronic injuries prevented her from achieving maximal medical recovery from the injuries that were exacerbated by the accident. Additionally, Adjudicator Sharda found that the claimant’s chronic pain injuries had continued over four years post-accident and therefore by definition were chronic. The claimant was thus entitled to the chronic pain treatment plan and the chronic pain assessment, as both were reasonable and necessary, and interest.

Full decision here

TGP Analysis

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  • FILED UNDER Medical Benefits, Minor Injury Guideline
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