Victory at the License Appeal Tribunal in Minor Injury Guideline Dispute
We are pleased to congratulate Senior Paralegal Maka Metreveli on a successful result for our client before the Licence Appeal Tribunal (LAT). This decision is a strong example of careful advocacy in a statutory accident benefits dispute, an area where insurers often have a clear advantage in resources and medical evidence.
Background
Our client was injured in a motor vehicle accident in 2024 and applied for accident benefits through her insurer. The insurer decided her injuries were "minor" as defined in Ontario's Statutory Accident Benefits Schedule. That placed her under the Minor Injury Guideline (MIG).
The MIG covers injuries such as sprains, strains and whiplash, and it sets a strict limit on the medical and rehabilitation funding available. Because the insurer applied the MIG, it denied several treatment plans that went over the limit. These included treatment aimed at the psychological effects of the accident. Our client disputed the denials and took the matter to the LAT, which decided it on written submissions.
The central issue
The main question before the Tribunal was whether our client's injuries were "predominantly minor." An injured person can be removed from the MIG if they show that their accident-related injuries go beyond the minor injury definition. The Tribunal has long recognized that a psychological impairment can be grounds for removal. The burden of proof rests with the injured person, so the evidence has to be persuasive.
The Tribunal's findings
The Tribunal found in our client's favour on this central issue. It concluded that she had a psychological impairment caused by the accident and removed her from the MIG.
The way the Tribunal treated the insurer's evidence is especially important.
The insurer's psychological assessment: The insurer's assessor concluded there was no psychological impairment. The Tribunal found that this conclusion was not supported by the assessor's own psychometric testing, which pointed to significant symptoms of depression and anxiety.
Our client's evidence: The Tribunal found that her own psychological evidence matched the results of the insurer's testing, and it preferred her assessor's diagnosis.
The insurer's psychiatric report: The Tribunal gave this report little weight. It noted that the report contained limited testing and did not deal with the full range of symptoms our client described. It also rejected the suggestion that being able to work and maintain personal relationships means a person has no psychological impairment.
The result
With the MIG limit lifted, the Tribunal found that our client was entitled to a psychological assessment and to ongoing psychological treatment, plus interest on the overdue amounts.
Why this decision matters
For many injured people, being placed under the MIG is the biggest obstacle to getting the care they need. This decision is an important reminder of three things:
Psychological injuries count. Anxiety, depression and driving-related phobias after an accident can be serious enough to take a claim outside the MIG, even when the physical injuries are relatively minor.
Insurer evidence is not the final word. The Tribunal will look closely at an insurer's own assessments, and it will not accept conclusions that the underlying data does not support.
Preparation matters. Success at the LAT depends on presenting clear, well-organized medical evidence and connecting it directly to each claim.
Congratulations again to Maka on this result, and thank you for the continued dedication you bring to our clients’ outcomes.
This article is for general information only and is not legal advice. If your accident benefits have been denied or limited under the Minor Injury Guideline, contact us to discuss your situation.