The Tribunal found that the Applicant’s injuries remained confined within the MIG, as such, the disputed treatment plan for physiotherapy services was not necessary to be considered, andno interest was owing.
Vice-Chair Julian DiBattista, agreeing with Definity’s submissions, found that the Applicant failed to establish that his injuries fell outside the MIG. The medical evidence, including a family physician note, physiotherapy report, and a disability certificate, described sprain and strain injuries affecting the cervical spine, lumbar spine, sacroiliac joint, and thumb, along with headaches. These injuries fall squarely within the definition of “minor injury” under the SABS. The Tribunal noted the absence of any diagnosis of chronic pain or how the pain was of a severity or nature that caused functional impairment sufficient for a MIG removal.
The Tribunal was not persuaded by the Applicant’s submissions that he could not return to work or resume normal activities, as these claims were not supported by sufficient medical evidence. Additionally, Vice-Chair Julian DiBattista stated that the Applicant referenced case law but did not connect it to the facts or evidence. As a result, the Tribunal concluded that the Applicant did not meet his burden of proving, on a balance of probabilities, that he should be removed from the MIG.
As the Applicant remained within the MIG, the Tribunal determined that it was unnecessary to assess the reasonableness and necessity of the disputed physiotherapy treatment plan, as funding was limited within the MIG framework. Finally, since no benefits were found to be payable, the Applicant was not entitled to interest. The Application was therefore dismissed in its entirety.
1. Jorabian v Definity Insurance Company, 2026 CanLII 29565 (ON LAT), <https://canlii.ca/t/kk785>
The Tribunal found that the Applicant sustained a minor injury and was subject to treatment within the MIG. The Tribunal found that the Applicant was not entitled to the OCF-18s in dispute or interest.
Adjudicator Rebecca Hines declined to address the procedural issue raised regarding the new records from Body Dynamics served within the Applicant’s written submissions, given that the “evidence had no bearing on the outcome” of the decision.
The Adjudicator found that the Applicant has not met his onus that he suffers from chronic pain as a result of the accident. Firstly, the evidence the Applicant relied upon was insufficient to support that he suffers from chronic pain as a result of the accident. The Tribunal found that the CNRS from his treating clinic was illegible and made no reference to any functional limitations as a result of ongoing pain. Secondly, the Applicant relied on the decision of T.S. v Aviva, 2018 CanLII 83520 (ON LAT) in support of his position that he should be removed from the MIG due to chronic pain. The Adjudicator found that the decision did not support his position as pain complaints must be more than sequelae of soft tissue injuries and must have an adverse impact on an individual’s wellbeing and functionally disabling.
Adjudicator found that the Applicant was not entitled to OCF-18s in dispute because it sought treatment outside the MIG. No interest was owing because no benefits were overdue. The Application was dismissed.
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