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A.V. v. Certas Direct Insurance Company (18-007875)

  • March 2, 2020

The claimant sought entitlement to NEBs, a determination that her impairments were outside of the MIG, and the cost of psychological assessment. Adjudicator Lake found that the claimant failed to prove on a balance of probabilities that she suffered from psychological issues or chronic pain arising from the accident and, as a result, her injuries did not fall outside of the MIG. Adjudicator Lake also denied entitlement to NEBs, as the claimant failed to prove on a balance of probabilities that she suffered a complete inability to carry on a normal life as a result of the accident. Lastly, Adjudicator Lake also found that the claimant was not entitled to the proposed psychological assessment, as she failed to prove that it was reasonable and necessary on a balance of probabilities. Of note, Adjudicator Lake indicated that the existence of psychological symptoms alone did not warrant a removal from the MIG, as precedent cases have noted that “psychosocial symptoms” can be considered a minor injury treatable within the MIG.

Full decision here

TGP Analysis

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  • FILED UNDER Non-Earner Benefits, Minor Injury Guideline
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