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Applicant v Wawanesa Mutual Insurance Company (17-007887)

  • August 28, 2018

The claimant disputed the insurer’s MIG determination and sought medical benefits for psychological assessment, psychological treatment, and chiropractic treatment, as well as a special award. Adjudicator Grant held that the claimant’s injuries were subject to treatment within the MIG and it was unnecessary to consider whether the treatment plans were reasonable and necessary. The claimant sustained soft-tissue injuries to his back, shoulder, and neck. The claimant subsequently injured his back changing a tire. The adjudicator could not conclude that the claimant’s impairment was solely from the accident. The adjudicator further held that the claimant’s physical injuries did not have a significant impact on his life or require any further treatment. The adjudicator further held that the claimant did not suffer from any accident-related psychological impairment that was significant enough to remove him from the MIG. The claimant’s psychological complaints did not amount to anything other than minor accident-related sequelae and he continued to participate in his regular pre-accident activities. The adjudicator preferred the insurer’s expert with respect to psychological impairment as the insurer’s expert’s opinion was corroborated by clinical notes and records. The adjudicator declined to award a special award as it was not unreasonable for the insurer to deny the treatment plans based on its interpretation of its assessors reports.

Full decision here

TGP Analysis

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  • FILED UNDER Minor Injury Guideline
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