What is the Minor Injury Guideline (MIG) in Ontario?
The Minor Injury Guideline (MIG) is a guideline set of rules introduced in Ontario in November 2011, defining what constitutes a "minor injury" following a motor vehicle accident.1 Its purpose is to limit the amount of medical and rehabilitation benefits available to individuals who sustain injuries that fall within the MIG's criteria. This is part of the Statutory Accident Benefits Schedule (SABS), which defines the benefits available to injured people from their own auto insurance.
The MIG applies specifically to injuries that are considered "minor", defined as typical soft-tissue injuries such as:
- Sprains and strains
- Whiplash-associated disorders
- Contusions (bruises)
- Abrasions (scrapes)
- Lacerations (cuts)
- Subluxations (partial dislocations)
If an injury is classified as a "minor injury" under the MIG, the individual is typically limited to $3,500 for medical and rehabilitation benefits under their automobile insurance policy. However, injuries that do not fall within the MIG (i.e., more severe injuries) may be eligible for a higher benefit cap, up to $65,000 for medical and rehabilitation services, or more depending on the degree of injury or optional benefits purchased.
How should health practitioners interpret the MIG?
Health practitioners—such as doctors, physiotherapists, and chiropractors—play a critical role in determining whether an injury falls within the MIG and whether treatment is appropriate within the MIG's limitations. Consideration when interpreting the guideline include:
Advisory nature of the MIG:
While the MIG provides guidelines for classifying injuries, it is advisory and not mandatory. The MIG should not be interpreted as an absolute rule but rather as a guideline. Every individual, and their injuries, must be assessed based on the medical evidence available and the patient's specific condition.
The role of credible medical evidence:
Health practitioners must rely on credible medical evidence to determine whether an injury meets the MIG's criteria. This includes:
- Clinical examination finding
- Medical history
- Diagnostic tests (e.g., X-rays, MRIs)
- Reports from specialists (e.g., orthopaedic surgeons, neurologists)
- Other relevant medical documentation
It is important that the decision is based on objective, professional judgment rather than assumptions or generalized interpretations of the MIG.
Consideration of pre-existing conditions:
The MIG does not automatically exclude individuals with pre-existing conditions. However, if a pre-existing condition is found to significantly hinder a person's ability to recover from a minor injury within the limits of the MIG (i.e., the $3,500 cap), then they may be excluded from the MIG classification and may be entitled to additional benefits.
Health practitioners should provide compelling medical evidence if a pre-existing condition is affecting recovery. This could include detailed explanations of how the pre-existing condition interferes with the treatment or recovery process.
Case-by-case basis:
The MIG is designed to be flexible. Health practitioners should assess each injury on a case-by-case basis, considering the unique circumstances of the patient. Even if an injury falls under the MIG's definition of a "minor injury," it may still require treatment outside of the MIG's constraints if the injury is more complex or recovery is hindered by other factors.
Ongoing review:
Health practitioners should remain open to reviewing and revising the diagnosis and treatment plan as more information becomes available. Injuries, especially soft tissue injuries, can evolve over time, and treatment needs may change. The decision about whether the MIG applies should be interim—meaning it can be revisited if new evidence or medical opinions arise.
Patient-centered care:
Ultimately, the health practitioner's role is to ensure that the patient receives the appropriate treatment for their recovery. If the MIG's limitations do not allow for adequate treatment, it is important that the practitioner documents and explains why treatment outside the MIG may be necessary.
Interpret the MIG with flexibility and prioritize your patient's individual needs
In summary, while the Minor Injury Guideline (MIG) provides a framework for classifying injuries and setting limits on accident benefits, health practitioners should interpret it with flexibility and a focus on individual patient needs. The MIG should be applied based on credible medical evidence, and pre-existing conditions or complex cases may justify treatment outside the MIG's limits. Each case should be evaluated on its own merits, with an open mind toward revising classifications as more information becomes available.
This approach ensures that the purpose of the MIG—to limit benefits for minor injuries—does not prevent individuals from receiving the appropriate care for their unique circumstances.
Footnote
1. Minor Injury Guideline, Superintendent's Guideline No. 01/14.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.