Minor Injury Guideline in Ontario: the $3,500 limit and how people get out of it

The Minor Injury Guideline (MIG) is the set of rules an Ontario insurer uses when it decides your car accident injuries are “minor”: sprains, strains, whiplash and similar soft-tissue injuries. If you are placed in the MIG, your medical and rehabilitation benefits are generally limited to $3,500. You can come out of the MIG if your injury falls outside the definition, for example a concussion or a diagnosed psychological impairment, or if a documented pre-existing condition will stop you from recovering within its limits.

What counts as a “minor injury” under the SABS?

The Statutory Accident Benefits Schedule (SABS, O. Reg. 34/10) defines a minor injury in section 3(1) as “one or more of a sprain, strain, whiplash associated disorder, contusion, abrasion, laceration or subluxation”, including “any clinically associated sequelae” of those injuries.

Section 18(1) then limits medical and rehabilitation benefits to $3,500 when a person’s impairments are “predominantly a minor injury”. That word “predominantly” matters. A person can have a sore neck and a concussion at the same time, and the question becomes which one drives the picture.

For comparison, the standard limit for non-catastrophic injuries outside the MIG is $65,000 for medical, rehabilitation and attendant care combined. The July 1, 2026 reform did not change these standard limits. You can read more in our article on the 2026 changes to Accident Benefits.

Sources: O. Reg. 34/10, sections 3(1), 18(1) and 18(2).

How does treatment work inside the MIG?

The MIG itself is a guideline issued by the regulator (Superintendent’s Guideline No. 01/14). It is built around a 12-week program in three four-week blocks. Your physiotherapist, chiropractor or other health practitioner sees you for an initial visit and then sends the insurer a Treatment Confirmation Form, the OCF-23, usually within 10 business days of that visit.

Treatment under the OCF-23 does not need the insurer’s approval in advance. That is the upside of the MIG. The downside is the ceiling: once the blocks and the $3,500 are used up, further care needs a Treatment and Assessment Plan (OCF-18), and the insurer can say no to it.

The guideline was designed for musculoskeletal injuries. Its only diagnostic test available without insurer approval is an X-ray, and its treatments are things like exercise programs, manual therapy and education. People with injuries that an X-ray cannot see often find out the hard way that the program does not fit them.

Concussion and the MIG: what changed in 2026

For years insurers argued that a brain contusion or concussion could stay in the MIG if the person seemed to be functioning reasonably well. Early in 2026 the Divisional Court rejected that approach.

In Marcelo v. The Personal Insurance Company, 2026 ONSC 974, a CT scan on the day of the accident showed a contusion in the brain. The Licence Appeal Tribunal had kept the claimant in the MIG, reasoning that “contusion” in the definition included brain contusions unless the resulting impairment was serious. The Divisional Court held that the definition is injury-based. The question is what the injury is, and the insurer’s view of how impaired the person looks does not decide it. The Court also pointed out that the SABS lists intracranial contusions among possible signs of catastrophic impairment, so it made no sense to call the same injury minor. The claimant was removed from the MIG.

The Tribunal has since applied Marcelo to concussion. In Zapanta v. Security National Insurance Company, 2026 ONLAT 24-010462/AABS (April 24, 2026), an emergency room physician had diagnosed a concussion and the insurer had no evidence against it. The Tribunal found the insurer was wrong to keep the claimant in the MIG after the hospital records arrived and ordered it to pay an award of 25% under section 10 of Regulation 664.

What this means in practice: if a doctor diagnosed a concussion or a head injury, that diagnosis needs to be in front of the insurer in writing. The emergency room record is often the most important document in the file.

Psychological injuries and the MIG

Psychological impairments are outside the definition of a minor injury. The Tribunal has repeated this many times, and it has also been clear about the limit: the person has to show a psychological impairment, which is more than psychological symptoms that come with a sore back.

Anxiety in the car, poor sleep and irritability are common after a crash. On their own, notes like these may be treated as “sequelae” of a soft-tissue injury and keep you in the MIG. What usually moves the case is a diagnosis from a professional who is qualified to make it, such as a psychologist or a physician, supported by records made over time.

In Torgbor v. TD General Insurance Company, 2026 CanLII 56654 (ON LAT), released June 5, 2026, the claimant came out of the MIG on the basis of a psychologist’s diagnosis, walk-in clinic notes about low mood, anxiety and insomnia, and a physiotherapist’s view that psychological symptoms were slowing physical recovery. The Tribunal gave less weight to the insurer’s psychologist, in part because the assessment used a single psychometric test designed for native English speakers.

That last detail is the reason we pay close attention to language in psychological assessments. Many of our clients came to Canada as adults. A questionnaire answered in a second language can make a person look less affected than they are. When we prepare a file, we ask which tests were used and in what language, and we can work with clients in English, Russian, Ukrainian and Armenian.

Pre-existing conditions

Section 18(2) of the SABS gives another way out. If a health practitioner provides compelling evidence that a pre-existing condition, documented before the accident, will prevent maximal recovery within the MIG limits, the $3,500 cap does not apply. The regulator’s guideline says this exception applies only in limited cases and that the evidence goes on an OCF-18.

A previous back injury does not automatically take you out of the MIG. Records from before the accident, showing the condition existed and how it affected you, are what make this argument work.

What can you do if the insurer keeps you in the MIG?

1. Ask for the reasons in writing. The insurer has to explain its decision. Keep the letter: the date you received a written denial matters for the 2-year limit to dispute it.
2. Collect the medical evidence. Emergency room records, family doctor notes, imaging, and any psychological or neurological assessment.
3. Ask your treating practitioner whether an OCF-18 for treatment outside the MIG, or for an assessment, is appropriate.
4. Attend any insurer examination you are properly asked to attend. Skipping it can block your dispute. Our article on insurer examinations explains what to check in the notice.
5. Dispute the decision at the Licence Appeal Tribunal if the insurer does not change its position. In a MIG dispute, the injured person has to prove on a balance of probabilities that the injury is outside the MIG. See what to do when Accident Benefits are denied.

If your injuries may be catastrophic, a paralegal cannot represent you on that Accident Benefits claim. In serious cases we work alongside personal injury lawyers. Read more in Paralegal or lawyer after a car accident in Ontario.

Frequently asked questions

VIA Legal Services Professional Corporation. Naira Velumyan is a Licensed Paralegal in Ontario (LSO #P21370). This article is for general informational purposes only and does not constitute legal advice for your specific situation.

Who handles your claim

Naira Velumyan is a Licensed Paralegal in Ontario and the founder of VIA Legal. She holds a PhD in Psychology, which shapes how she handles psychological injury claims. Read more about Naira