If you are involved in a car accident in Ontario, then the damages to which you are entitled are dictated, at least in part, under the province’s insurance laws, specifically by the Statutory Accident Benefits Schedule of Ontario’s Insurance Act. The Statutory Accident Benefits Schedule includes a section that limits the damages to which a person is entitled if they suffer only minor injuries. These are called the Minor Injury Guidelines.
This blog discusses the Minor Injury Guidelines, including what constitutes a minor injury, how the guidelines are applied, and the implications of their application.
What is the Statutory Accidents Benefits Schedule?
The Statutory Accidents Benefits Schedule, or ‘SABS’, is a legislative scheme that operates to provide certainty to parties involved in motor vehicle accidents in Ontario. The regulation dictates how much money victims of accidents are entitled to recover in the form of income replacement, non-earner and caregiver benefits, medical, rehabilitation and attendant care benefits, and payment of other expenses such as housekeeping/home maintenance fees and death and funeral benefits.
The scheme also includes guidance on how to claim such damages and the expectations of a victim in terms of responsibility to seek and obtain treatment for injuries suffered, participate in any necessary rehabilitative processes, and seek employment in the event their employment was lost due to limitations imposed by injuries suffered in an accident.
What are the Minor Injury Guidelines, and When Do They Apply?
The Minor Injury Guidelines were introduced in 2010 to address compensation for minor injuries. The MIG operates in such a manner as to limit compensation for minor injuries to only $3,500 in total for all related costs, including health care expenses, attendant care expenses, and lost income. The term “minor injury” is defined by the SABS as strains, whiplash-related disorders, and sprains.
The Minor Injury Guidelines are applicable in all circumstances in which a person suffers only minor injuries in an accident. That said, a person may escape the application of the MIG in the event they can prove that their accident-related injuries are so extensive as to fail to qualify as ‘minor,’ or they can prove that the minor injury suffered in the relevant accident exacerbated a pre-existing injury or condition such that the victim now suffers from a major injury. Significantly, the relevant tribunal (the Licence Appeal Tribunal) and the courts have established that, in some circumstances, chronic pain may qualify as an injury so major as to warrant the removal of the victim from the confines of the application of the Minor Injury Guidelines.
How Minor is Minor? A Tale of Three Injuries
As mentioned above, the Minor Injury Guidelines apply only to minor injuries. The definition of what constitutes a ‘minor injury’ under the SABS is not exhaustive; as a result, the nature of many injuries is left to the court’s discretion. So, how minor is it? In other words, what will be considered an actual minor injury, and what type of injury may be considered so severe as to escape categorization as ‘minor’?
Significant, Expensive Dental Work Constitutes “Minor” Injury
The recent Licence Appeal Tribunal decision in Ovramenko v Certas Home and Auto Insurance Company involved an applicant who sought damages for injuries suffered in a car accident. The applicant contended that he had sustained significant injury as a result of the accident, including to his left leg, his jaw, neck and back, amongst other injuries. In particular, the applicant asserted that he had experienced significant pain in his teeth and lower jaw shortly after the accident, and dental issues escalated after the accident to the point that he required extensive dental surgery and reconstruction that cost in the neighbourhood of $50,000. Given his extensive dental issues post-accident, the applicant sought a declaration that his injuries were not minor and payment of compensation beyond $3,500 for the expenses he had incurred to treat the injuries suffered in the accident.
The tribunal noted that the applicant had failed to provide any evidence to link the nature of his injuries, particularly his dental injuries, to the accident in which he had been involved. Moreover, the dental records that the applicant had submitted as evidence indicated that the applicant had suffered from extensive dental issues for some time before the accident. It was impossible to discern whether the accident contributed to or exacerbated those issues or whether all of the dental work the applicant had undertaken would have been necessary, even if the accident had never occurred. In these circumstances, the tribunal was satisfied that the applicant had not established that the accident was the cause of his major dental issues, and it declined to find that the applicant’s injuries were not of a minor nature.
Claim of Chronic Pain, Unsubstantiated by Medical Records, Fails to Constitute Major Injury
In Moulton v Certas Direct Insurance Company, the applicant sought payment of damages related to injuries suffered in a car accident in 2017. In particular, the applicant alleged that he suffered from chronic pain as a result of the injuries sustained in the accident. For that reason, his injuries should be considered major rather than minor.
Although the tribunal acknowledged that chronic pain may, in some circumstances, qualify an injury as major instead of minor, it was unable to make such a conclusion in this case. This is because the applicant, in this case, had failed to provide any medical evidence to substantiate his claim that he suffered from chronic pain. The applicant had visited his family physician only twice in the aftermath of the accident (once immediately after the accident and once again more than one year later) and had attended only six physiotherapy sessions nearly a decade earlier, in the weeks immediately following the accident. The applicant provided no evidence to the tribunal to indicate that he had been diagnosed with chronic pain by any qualified medical professional. In fact, the tribunal noted that the applicant had never received such a diagnosis. The applicant’s failure to provide medical substantiation of his claimed condition was fatal to his claim that the injuries suffered were major.
Psychological Injury Qualifies as Major Injury
The case of Skanes v Wawanesa Mutual Insurance Company involved an applicant who alleged that he suffered extensive psychological injury as a result of a car accident in which he had been involved in 2021. The applicant sought compensation for the injuries he alleged were not minor and, therefore, not subject to the limitations imposed by the Minor Injury Guidelines.
The applicant furnished the tribunal with the medical records of his treating physiotherapist, family physician and treating psychologist to substantiate his claim of major psychological injury. In particular, the tribunal noted that the physiotherapist had recorded the applicant’s complaint of difficulty concentrating and issues with memory and sleep in the aftermath of the accident, as had the applicant’s family physician. Furthermore, the applicant had attended a psychological evaluation, as a result of which he had been diagnosed with several ailments, including somatic symptom disorder and adjustment disorder complicated by anxiety, depression and post-traumatic stress, all of which issues were directly related to the accident.
Given that the applicant had been provided medical diagnoses by qualified medical professionals for the injuries suffered directly as a result of the accident, the tribunal was satisfied that the evidence proved, on the balance of probabilities (i.e., to a certainty of 51%), that the applicant had suffered psychological impairment as a result of the accident such that his injuries fell outside the range applicable to minor injuries. The Minor Injury Guidelines were inapplicable in his case.
Ottawa Personal Injury Lawyers Assisting You with Your Accident-Related Injury Claim
If you’ve been involved in a car accident in Ontario and are unsure whether your injuries qualify as minor or major, seeking legal advice is crucial. Contact our experienced personal injury lawyers at Tierney Stauffer LLP to discuss your case. We can help you understand your rights, assess the severity of your injuries, and determine whether the Minor Injury Guidelines apply to your situation.
Our team will work tirelessly to ensure you receive the full compensation you deserve for your injuries and losses. Call 1-888-799-8057 or contact us online to schedule a consultation today to learn more about how we can assist you.
