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Applicant v. TD Home & Auto Insurance Company (17-006571)

  • October 4, 2018

The claimant sought a determination that his impairments were outside of the MIG and entitlement to benefits proposed in 12 treatment plans. The claimant relied on a chiropractor’s diagnosis of depressive symptoms, PTSD, and a chronic pain condition. Adjudicator Grant placed very little weight on the chiropractor’s findings as the psychological diagnosis was beyond the chiropractor’s area of expertise and the chiropractor did not provide guidance on how the chronic pain “condition” (as opposed to chronic pain “syndrome”) lifted the claimant outside of the MIG. Adjudicator Grant found that the claimant did not provide compelling evidence that his pre-existing degenerative changes in the lumbar spine were worsened by the accident or that his recovery was impeded by the pre-existing condition. Adjudicator Grant 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.

Full decision here

TGP Analysis

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  • FILED UNDER Minor Injury Guideline
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