S.B. and Aviva General Insurance
May 15, 2017
Adjudicated by Derek Grant
The Applicant applied for income replacement benefits and was denied. He also applied for chiropractic treatment that was denied because the Applicant had already exhausted the $3,500 statutory limit under the Schedule.
Issue One: MIG Determination: The Applicant failed to establish his entitlement to benefits beyond the Minor Injury Guideline. No evidence was brought forth by the Applicant at all.
Issue Two: Medical benefit for additional physiotherapy treatment: As a result of the Applicant’s determination within the Minor Injury Guideline, the physiotherapy treatment was denied, as it ran in excess of the $3,500.00 entitlement under the Minor Injury Guideline.
Issue Three: Income replacement benefit: The Applicant only submitted an OCF-3 Disability Certificate with no further evidence about his inability to work. His chiropractor confirmed that he could return to work on modified hours and/or duties. The evidence supported the conclusion that the Applicant was able to perform the essential tasks of his employment, based on the evidence provided by the Respondent.