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M.D. v. Certas Home and Auto Insurance Company (18-011652)

  • February 24, 2020

The claimant sought a determination that his impairments were outside of the MIG and entitlement to medical benefits proposed in two treatment and assessment plans for physiotherapy services and a chronic pain assessment. Adjudicator Grant found that the claimant’s chronic pain took him outside of the MIG, based on the chronic pain assessment report of Dr. Karmy, a chronic pain specialist. Based on the length and history of the claimant’s pain complaints and the goal of achieving pain relief, Adjudicator Grant found the chronic pain assessment and physiotherapy treatment plan to be reasonable and necessary.

Full decision here

TGP Analysis

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  • FILED UNDER Medical Benefits, Minor Injury Guideline
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