Case snapshot
At a glance
- Case
- Can You Be Removed from the MIG for Chronic Pain in Ontario?
- Court / Tribunal
- ONLAT
- Citation
- 2026 CanLII 106180 (ON LAT) ↗
- Date
- October 6, 2026
- Area of law
- Motor Vehicle Accident
- Key issue
- Whether an accident victim's injuries qualified as predominantly minor under the Minor Injury Guideline, and whether the victim was entitled to an income replacement benefit and psychological treatment funding.
- Outcome
- The Licence Appeal Tribunal found that the applicant's injuries remained within the Minor Injury Guideline and denied the claims for income replacement benefits, psychological treatment funding, interest, and an award against the insurer.
- Why it matters
- This decision shows the kind of evidence Ontario's Licence Appeal Tribunal expects before it will move an accident benefits claim outside the Minor Injury Guideline: objective medical evidence and clinical records, not just self-reported symptoms, a chiropractor's testimony, or a psychologist's intake interview.
Legal principle
The rule from this case
Under Ontario's Statutory Accident Benefits Schedule, medical and rehabilitation benefits are limited to $3,500 where an insured's impairments are predominantly a minor injury, such as a sprain, strain, whiplash-associated disorder, contusion, abrasion, laceration or subluxation. To get out of the MIG, the injured person must prove on a balance of probabilities that their injuries are not predominantly minor. As the Tribunal described, recognized pathways include chronic pain with functional impairment, an accident-related psychological condition, or a documented pre-existing condition combined with compelling medical evidence that it precludes recovery within the MIG. For income replacement benefits in the first 104 weeks, an applicant who was employed at the time of the accident must show a substantial inability to perform the essential tasks of that employment as a result of the accident. The burden of proof is on the applicant. In this case, the Tribunal treated self-completed T1 tax forms as less reliable than Canada Revenue Agency notices of assessment, and drew an adverse inference against the applicant for not producing documents required by a case conference order.
Important limits
What this does not mean
This decision does not mean that chronic pain or psychological injuries can never take a claimant outside the MIG. The Tribunal acknowledged that chronic pain with functional impairment or a psychological condition may warrant removal from the MIG; the claimant in this case simply did not provide enough objective, corroborating evidence to meet that standard. It also does not mean a treating chiropractor's or psychologist's evidence can never help. Here, the Tribunal gave little weight to the chiropractor's testimony because his clinical notes and records were not produced and he was not an expert, and it gave little weight to the psychologist's impressions because they came from a 45-minute intake interview with no testing or formal assessment. A claim supported by clinical records and proper assessments may be in a different position.
What Does It Take to Get Out of the Minor Injury Guideline in Ontario?
Getting removed from the Minor Injury Guideline (MIG) requires objective, corroborating medical evidence — not just a claimant’s own testimony or a single treatment plan. The MIG caps medical and rehabilitation benefits at $3,500 for injuries classified as predominantly minor, such as sprains, strains, and whiplash. To exceed that cap, a claimant must prove their injuries fall outside that definition, typically by establishing chronic pain with functional impairment or a psychological condition linked to the accident.
In Heydararabi v. Certas Direct Insurance Company, 2026 CanLII 106180 (ON LAT), the Licence Appeal Tribunal considered whether a claimant injured in a March 2023 automobile collision had produced enough evidence to escape the MIG. The tribunal concluded he had not.
What Evidence Does the Tribunal Look for When Assessing Chronic Pain?
The tribunal looks for objective diagnoses from qualified experts and corroborating clinical notes and records from treating physicians — not just a claimant’s self-reported symptoms. In this case, the claimant described ongoing neck, back, shoulder, wrist, knee, and elbow pain, as well as numbness, tremors, headaches, dizziness, and sleep disruption. However, no expert report formally diagnosed chronic pain or chronic pain syndrome, and no clinical notes from treating physicians were filed to confirm those complaints.
The treating chiropractor testified about the claimant’s symptoms, but the Tribunal did not place much weight on that testimony because he was not an expert and his clinical notes and records were not produced. Without independent medical assessments or physician records corroborating the severity of the claimant’s condition, the chronic pain argument failed.
Can a Psychological Condition Remove You from the MIG?
Yes, an accident-related psychological condition may support removal from the MIG, but the Tribunal looked for objective, corroborating evidence. Here, a clinical psychologist testified about the claimant’s poor sleep, diminished concentration, low mood and hopelessness, and described adjustment disorder among other problems. However, her observations came from a single 45-minute intake interview with no formal testing and no independent assessment.
The Tribunal said her impressions were not diagnoses, noted that it has consistently found OCF-18 treatment plans are not medical documents, and found no clinical notes and records or independent medical assessments confirming any psychological condition. This argument also failed.
How Does Missing Financial Documentation Affect an Income Replacement Benefit Claim?
Failing to produce key financial records can seriously undermine an income replacement benefit (IRB) claim and may lead the tribunal to draw an adverse inference against the claimant. To qualify for an IRB in the first 104 weeks after a collision, a claimant must show they were employed at the time and suffered a substantial inability to perform the essential tasks of that job.
In this case, the claimant, a self-employed contractor who worked at his brother’s heating, ventilation and air conditioning company, did not produce Canada Revenue Agency notices of assessment, employment insurance records, or records of employment. The only tax documents filed were self-completed T1 forms, which the tribunal found less reliable than government-verified assessments. Because the claimant had not complied with a case conference order to produce notices of assessment, the Tribunal drew an adverse inference and said the missing records also called his credibility into question. He also testified that he worked as a manager at his brother’s café from about February 2024 to February 2026, and the Tribunal was not persuaded that he was unable to perform the essential tasks of his pre-accident employment.
What Happens to a Treatment Plan Claim If You Stay Within the MIG?
In this case, the parties agreed the $3,500 MIG limit had been exhausted, so once the claimant remained within the MIG, the Tribunal found it unnecessary to decide whether the disputed treatment plan was reasonable and necessary. The claimant here sought $2,200 for psychological services. Because he remained within the MIG and the MIG funds were exhausted, he was found not entitled to it.
This outcome underscores why the MIG removal question is so pivotal: it determines not just the overall funding cap, but whether specific treatment plans will even be evaluated on their merits. Our Ontario accident benefits lawyers can help you understand how these thresholds apply to your situation.
Can an Insurer Be Penalized for Unreasonably Withholding Benefits?
Under s. 10 of Regulation 664, the Tribunal may grant an award of up to 50 per cent of the total benefits payable if it finds that an insurer unreasonably withheld or delayed payment. In this case, the Tribunal found the insurer had adjusted the file on a timely basis, did not receive timely responses to its own requests to the applicant (including a request for financial documentation), and made denials based on a lack of information provided by the applicant. The award claim was denied.
The Tribunal referred to the description of the required conduct in the Financial Services Commission of Ontario decision Plowright v. Wellington Insurance Company (1993): conduct that is “excessive, imprudent, stubborn, inflexible, unyielding or immoderate.” The applicant here did not provide evidence of that kind of conduct.
Questions and Records to Discuss with a Lawyer
- What medical records, clinical notes, and expert assessments have been gathered since the accident, and are there any gaps that could weaken a MIG removal argument?
- Has a formal psychological assessment (not just an intake interview) been completed by a qualified mental health professional?
- Are all employment records, CRA notices of assessment, and records of employment available and ready to produce if requested?
- Has the insurer been notified of any change of address, and have all correspondence and denial letters been reviewed carefully?
- What specific tasks were performed in pre-accident employment, and is there medical documentation linking the accident injuries to an inability to perform those tasks?
If you have questions about your own accident benefits claim or want to understand how the MIG applies to your injuries, the team at UL Lawyers is available to discuss your circumstances. Reach out through our motor vehicle accident practice page or contact us directly at /connect.
This article is automated commentary on a public court decision and is for general information only — not legal advice. Decisions rely on facts unique to each case. If you are affected by a similar issue, contact a lawyer for advice specific to your situation.
FAQ
Frequently asked questions
The MIG applies under Ontario's Statutory Accident Benefits Schedule when accident injuries are predominantly minor, meaning sprains, strains, whiplash-associated disorders, contusions, abrasions, lacerations, subluxations and their clinically associated sequelae. Medical and rehabilitation benefits for those injuries are limited to $3,500 unless the claimant proves the injuries fall outside the MIG.
The burden is on the claimant. As this decision describes, the Tribunal may remove a claimant from the MIG for chronic pain with functional impairment, an accident-related psychological condition, or a documented pre-existing condition with compelling medical evidence that it would prevent recovery within the MIG. In this case, the claimant's own testimony, a chiropractor's testimony without his clinical notes and records, and a psychologist's intake-interview impressions were not enough.
An income replacement benefit (IRB) is a weekly accident benefit for lost income. As the Tribunal described the test in this case, an applicant who was employed at the time of the accident must show that, as a result of and within 104 weeks after the accident, they suffered a substantial inability to perform the essential tasks of that employment. The applicant bears the burden of proof, and here missing employment and tax records counted against the claim.