What exactly is a minor injury when it comes to Ontario accident benefits?

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What exactly is a minor injury when it comes to Ontario accident benefits?

MINOR INJURY GUIDELINE (MIG) FOR MOTOR VEHICLE INSURANCE

slip and fall accident

per s.268.3 of the Statutory Accident Benefits Schedule – HIGHLIGHTS

This Guideline is focused on the application of a functional restoration approach in the management of minor injuries in the acute and sub-acute phases of the injury.

For the purposes of this Minor Injury Guideline:

  • a) minor injury means a sprain, strain, whiplash-associated disorder, contusion, abrasion, laceration or subluxation and any clinically associated sequelae. This term is to be interpreted to apply where a person sustains any one or more of these injuries.
  • b) sprain means an injury to one or more tendons or ligaments or to one or more of each, including a partial but not a complete tear.
  • c) strain means an injury to one or more muscles, including a partial but not a complete tear.
  • d) subluxation means a partial but not a complete dislocation of a joint.
  • e) whiplash injury means an injury that occurs to a person’s neck following a sudden acceleration-deceleration force.
  • f) whiplash associated disorder means a whiplash injury that:
  • (i) does not exhibit objective, demonstrable, definable and clinically relevant neurological signs, and
  • (ii) does not exhibit a fracture in or dislocation of the spine.

Exceptions: An insured person’s impairment does not come within the MIG if the insured person’s impairment is predominantly a minor injury but, based on compelling evidence provided by his or her health practitioner, the insured person has a pre-existing medical condition that was documented by a health practitioner before the accident and that will prevent the insured person from achieving maximal recovery from the minor injury if he or she is subject to the $3,500 limit referred to in section 18(1) of the SABS or is limited to the goods and services authorized under this Guideline.

The MIG does NOT include concussion/TBI, or psychological impairments such as anxiety disorder.

  • Duration of benefits: treatments provided will not typically exceed twelve weeks in duration following the date of the initial visit
  • Total funding for benefits: $3,500
  • Goods and services provided: Assessment, treatments, equipment (therabands, gym ball, lumbar roll), assistive devices.
  • Treatments to include. Activity Prescription; Education; Reassurance; Home Exercise, treatments for: pain management, increased function, and diagnostic imaging.

Still have a question about the Minor Injury Guideline or Ontario Accident Benefits?

For a complete copy of the Minor Injury Guideline with Fee Schedule for services, please see the Financial Services Commission of Ontario website www.fsco.gov.on.ca or www.ottawainjury.ca/insurance-claims/

About the Author

David Hollingsworth has been a personal injury lawyer in Ottawa since 1999. David dedicates himself to helping people who have been injured in an accident, including car accidents, slip and fall accidents, motorcycle accidents, LTD claims, Accident Benefits claims and more. David and his team work closely with their clients and their families and help rebuild lives, following a traumatic accident. To learn more about David Hollingsworth, view his full profile.