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  MIG Update – September 29, 2025

Chronic Pain Is Not Just a Matter of Time

This week, we highlight a MIG hold case in which the Tribunal addressed a recurring issue in MIG determinations: whether injuries lasting more than six months should automatically be considered ‘chronic’ and therefore fall outside the MIG. While the Applicant made reference to a case to support this position, the Tribunal focused on whether there was clear and compelling medical evidence to substantiate the claim.

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In Mengestu v. Certas Home and Auto Insurance Company (23-008327), Ahmed Mengestu was involved in an accident on January 18, 2020 and sought entitlement to five Treatment Plans for nursing assessment, orthopedic assessment, psychological assessment, CAT assessment and physiotherapy services totaling $41,831.06 as well as an OCF-3 in the amount of $200. He submitted that he should be removed from the MIG, as he suffered from chronic pain as a result of the accident.

Mengestu argued “injuries of more than 6 months are classified as ‘chronic’ injuries and chronic injuries do not fall within the MIG” and that their injuries have continued for many years. Further that the test for chronic pain was set out in Z.L. v, Northbridge (18-005777) and involves consideration of the following three factors”:

a) The insured suffers from significant and constant pain – more than simple ongoing or recurrent pain.

b) The pain has persisted well beyond the normal healing time for the injuries sustained; and

c) The individual’s pain causes functional impairment and disability, specifically with respect to functional abilities.

Certas argues that the medical evidence submitted by Mengestu, namely the K-W Urgent Care Clinic – clinical notes and records dated April 9, 2020 do not support a diagnosis of chronic pain. Further that the allegations contained in Mengestu’s submissions are not evidence in and of themselves.

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The Tribunal found:

• “In my view, in order to be taken out of the MIG due to chronic pain, there must be evidence of severe or functionally disabling pain that is constant and affects the applicant’s day to day or work function. The pain must be continuous (in that the initial minor injury never fully healed) and must be of a severity that it causes suffering and distress accompanied by functional impairment or disability. To meet the applicant’s burden to show that chronic pain is more than mere sequelae from his soft tissue injuries there must be a discussion of the level of pain, its effect on the person’s function, and whether the pain is bearable without treatment.”
• Mengestu did not point to any evidence that supported a diagnosis of chronic pain that his submissions are not evidence in of themselves the submissions referenced did not not support a diagnosis of chronic pain.
• “Although not bound by the decision in Z.L. v Northbridge I find it a helpful guide in assessing whether an individual suffers from chronic pain or chronic pain syndrome. However, I find that the applicant has not adduced any evidence that meets any of the criteria set out in Z.L. v Northbridge.

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