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  MIG Update – February 9, 2026

Meniscal Tear – Age Related or Caused by MVA?

This week’s review examines an MIG escape wherein the Tribunal considered whether the Applicant’s left knee injury was a result of age-related degeneration or caused by the MVA in question.

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In Marciniak v. Coachman Insurance Company (24- 001644), Marc Marciniak was involved in an accident on June 5, 2018 and sought entitlement to five Treatment Plans for Synvisc injection treatment, chiropractic and massage therapy services totaling $8,985.44. He submitted that he should be removed from the MIG, on the basis that he was diagnosed with a meniscal tear in his left knee as a result of the accident.

Marciniak submitted that the tear was first identified in an MRI report dated April 2019, and subsequently he underwent arthroscopic surgery of his left knee to repair the injury in October 2019. He also submitted that he was entitled to the Treatment Plans proposing injection treatments, as his orthopaedic surgeon, Dr. Sayed’s CNRs support that these injections were consistently prescribed to address the accident-related pain in his left knee, as they provided relief.

Coachman contended that Marciniak failed to prove that the meniscus tear was caused by the accident. It argued the tear was a result of age-related degeneration rather than trauma. To support this, they pointed to a 2013 MRI showing a similar meniscal tear in Marciniak’s right knee, suggesting a pattern of natural progression.

In reply Marciniak maintained that the complaints and physical limitations regarding his left knee only began to be observed following the subject accident, disputing Coachman’s theory of pre-existing degeneration.

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The Tribunal found:

• • “I note that the respondent’s theory that the applicant’s left knee meniscal tear is the result of general degeneration, as previously reflected in the right knee, is not supported by any s. 44 assessment or medical opinion. Rather, these assessments are silent on the left knee meniscal tear identified in 2019 and the right knee meniscal tear identified in 2013.
    
  • Coachman mischaracterized the right knee as age-related degeneration when in fact it was as a result of a previous MVA and subsequent surgery.
    
  • Dr. Dessouki’s September 2021 IE report confirmed the 2019 MRI showed the original tear from that accident had since healed.
    
  • The documented complaints and limitations in the left knee only began to be observed following the subject accident.
    
  • The treatment plans in dispute were all found reasonable and necessary as Coachman did not specially address the necessity of each plan rather relied solely on the argument that the MIG funding cap has been reached.
    

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