In Ontario, the process of receiving benefits from your auto insurer after you have sustained injuries in a motor vehicle accident can be complex and confusing. Among the key factors influencing the accident benefits process are the Minor Injury Guidelines (MIG), which govern the treatment and compensation for certain types of injuries.
The MIG provides a framework for assessing and treating injuries resulting from motor vehicle accidents. If your injuries fall under the MIG, they are considered “minor” in nature. These injuries include soft tissue injuries such as strains, sprains, whiplash-associated disorders, certain types of contusions and bruises, and superficial abrasions and lacerations.
If your injuries are considered “minor,” then you are only entitled to receive up to $3,500 in medical and rehabilitation benefits from your accident benefits insurer. This amount is intended to be able to cover reasonable and necessary expenses related to the treatment of your minor injuries, such as physiotherapy, chiropractic care, and massage therapy.
Classifying your injuries as minor allows insurance companies to streamline their processes and approve you for the minimum amount of treatment without much hassle. Your entitlement to treatment is intended to match the expected severity and recovery period of your injuries as reported by your treating medical professionals.
However, the MIG is not perfect, and individuals will very often see that the treatment provided under the MIG is not enough to adequately deal with their collision-related injuries. If your injuries are considered to fall outside of the MIG, then you will be entitled to a significantly larger amount of treatment. Some of those injuries include:
- Chronic pain: If your injury leads to a chronic pain condition that persists beyond the typical recovery period, it may be considered outside the guidelines. Despite jurisprudence from the License Appeal Tribunal that confirms that chronic pain conditions can remove individuals from the MIG, accident benefit insurers will often argue that your chronic pain symptoms still fall within the MIG and do not qualify you for further treatment. This is why it is crucial to have medical professionals who consistently and accurately report on the chronicity of your symptoms, as well as the functional limitations that you suffer daily as a result of your pain.
- Serious impairment: Injuries that result in serious impairment of your physical and psychological functions can entitle you to further benefits. This means that your ability to carry out your daily activities have been seriously impacted from your collision-related injuries. The most common example of this is a fracture which leaves you unable to walk or move parts of your body for an extended period of time. Do not forget however that this also includes your mental wellbeing – a diagnosis of anxiety or depression as a result of the accident is a great example of an injury that can entitle you to further treatment.
- Pre-existing conditions: If an individual has pre-existing medical conditions that are exacerbated or aggravated by the collision, their injuries may be considered outside the MIG. In order to prove this, an individual must show that the pre-existing condition was documented by a health practitioner prior to the accident, and the pre-existing condition will prevent maximal recovery of the collision-related injuries if the person is subject to the MIG limits.
It is important to have a qualified personal injury lawyer assess your case if your accident benefits insurer has deemed that your injuries are minor, as you may be entitled to more benefits than they let on. Our team at JEWELL RADIMISIS JORGE LL.P can help you dispute your accident benefits entitlement, and use our expertise to help prove why you are entitled to more treatment.