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  MIG Update – December 1, 2025

When Chronic Pain Isn’t Enough

The Tribunal continues to hold that chronic pain, on its own, does not remove a claimant from the MIG without clear evidence of ongoing functional impairment, a chronic pain diagnosis is insufficient to establish a non-minor injury. This week’s case review highlights these principles, illustrating how arguments and case precedents can fall short when the evidentiary record does not substantiate a chronic pain escape.

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In Phillips v. Aviva Insurance Company of Canada (24-003308), Stephen Phillips was involved in an accident on December 12, 2021 and sought entitlement to two Treatment Plans for chiropractic services. He submitted that he should be removed from the MIG, as he suffered from chronic pain as a result of the accident.

Phillips relied on the treatment records from his chiropractic and physiotherapy clinic, to argue that he attended physiotherapy from 2021 to 2023, and that given his persistent neck, shoulder and back pain, he clearly developed chronic pain as a result of the accident. He cited the Tribunal decision Raja-Mohamad v. The Personal Insurance Company, (20-005623) to argue that a claimant reporting pain to his treatment providers is sufficient to justify ongoing treatment, even if there are a lack of formal complaints to the family doctor.

Phillips also relied on a reporting letter from the pain clinic dated September 2024, where Dr. Chan diagnosed him with myofascial pain, mechanical neck and low back pain, upper crossed syndrome and chronic pain syndrome.

Aviva submitted that Phillip”s had not established chronic pain, as the family physician and walk-in clinic CNRs revealed that he only attended a few times in the years post-accident and had been diagnosed only with “muscle pain/spasm” as a result of the accident. Rather, it argued that Phillips sustained a more serious impairment from a workplace injury where he wrenched his back when he slipped stepping off his truck in November 2022 for which he filed a WSIB claim.

Aviva argued that Phillips only began physiotherapy after the workplace accident. It further submitted that, despite the more serious November 2022 injury, he had returned to full duties by January 2023 and reported little to no functional impairment. In addition the August 2023 IE report from Dr. Bansal noted a full active range of motion in the shoulders and cervical and lumbar spine, and described the injuries as uncomplicated, self-resolving soft-tissue injuries to the neck and back.

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The Tribunal found:

• The CNR’s from Phillip’s walk-in clinic and family doctor contain few reports of post-accident pain or impairments.
  
• Although Phillips relies on Raja-Mohamad v. The Personal Insurance Company to argue that his physiotherapy pain reports are enough to justify ongoing treatment, the physiotherapy records themselves show only intermittent treatment. Notably, while a walk-in clinic doctor recommended physiotherapy on December 27, 2021, just a week after the accident, he did not begin such treatment until nearly a year later in November 2022, following his workplace fall.
  
• The WSIB records reveal after 2 months of physio Phillips reported a 9/10 ability to perform activities at the same level as before the workplace injury. He returned to work on regular duties and hours to his role as a truck driver. He did not return to physio again until March 2024.
• …”While I agree with the applicant that treatment records can be evidence of persistent pain reports, in this case, they have only been provided for a short duration. This, together with the lack of persistent pain reports to the applicant’s family doctor, in my view, does not support a finding of ongoing chronic pain post-accident.”
  
• The reporting letter dated September 27, 2024 from the Vaughan Pain Clinic to be of limited persuasive value as the assessor did not appear to have reviewed any medical records and relied almost solely on Phillip’s self-reports of ongoing pain and functional limitations with no details on the specific functional limitation.
• Phillips did not provide any rebuttal evidence to the August 25, 2023 IE report of Dr. Bansal who diagnosed Phillips with uncomplicated self-resolving soft tissue injuries to the neck and back as a result of the subject accident.

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