A recent decision of an arbitrator has confirmed that chronic pain syndrome can be enough to get an accident victim out of the Minor Injury Guideline. Under the guideline accident victims are entitled to significantly reduced medical and rehabilitation benefits.
In Arruda v. Western Assurance Company the insured accident victim suffered from soft tissue injuries and psychological impairments arising from her physical injuries. After Ms. Arruda’s medical and rehabilitation benefits were exhausted under the Minor Injury Guidline she applied for further treatment which was denied. Ms. Arruda’s injuries had initially been described as muscle and ligament strains and sprains. But twenty months post-accident her injuries had failed to resolve and she was diagnosed with a chronic pain disorder. The arbitrator found that the insurer had failed to reassess the claim when they received the new information that Ms. Arruda had been diagnosed with a chronic pain disorder. The arbitrator also held that that the insurer could not rely on year-old independent examinations in response to the new diagnosis.
This is an important decision in favor of accident victims who need treatment. Even if an injury is initially described as predominantly a soft tissue injury (a so-called “minor injury”) if it develops into a pain disorder the insurer can be forced to fund additional treatments beyond the Minor Injury Guideline limit.
If you have suffered injuries that your insurer describes as “minor” but your symptoms persist, speak to one of our lawyers. We will conduct a thorough review of your situation to make sure that you receive the treatment you need to recovery from your injuries.
To arrange a free initial consultation with one of your lawyers, contact us at 613-238-1424 or complete our online form.