MIG Update – April 28, 2025
MIG Not Conceded Despite Approved CAT Assessments
This week’s MIG hold case, where the Tribunal considered a significant history from two prior accidents and what if any new injuries or exacerbations were caused by the subject accident. The Tribunal further considered whether the Respondent’s approval of the suite of CAT assessments was an implicit concession that an Applicant’s injuries are not MIG?
With 1700+ MIG decisions determined by the LAT so far… we provide research support that gives you answers.
Virtual Training – Upcoming Sessions
Secure your seat for inHEALTH’s 2025 upcoming Virtual Training sessions!
- SABS Expedited: May 5-9, 2025
*Eligible Participants receive 9 Substantive – CPD hours upon course completion
Course details & register here +
Factor: Pre-Existing
In Wildman v. Economical Insurance Company (22-014032), Carrie Wildman was involved in an accident on December 17, 2019, and sought entitlement to NEBs, various treatment plans for physiotherapy, OT services and the balance of the partially approved Catastrophic assessment.
Wildman had significant documented pre-existing injuries, including a traumatic brain injury in 2006 for which she was still off work at the time of the subject accident, and a 2018 motor vehicle accident that exacerbated her injuries for which she was still receiving physiotherapy and psychotherapy treatment at the time fo the subject accident. She submitted that she should be removed from the MIG based on a pre-existing condition, concussion, chronic pain, psychological impairment, and the fact that she was partially approved for a CAT assessment.
The tribunal found there was no discernible difference between Wildman’s life before the accident and during the claim period and did not grant entitlement to the NEB. The focus turned to whether Wildman met her burden to prove her injuries were not MIG.
Get Your Stats Report!
inHEALTH’s Statistical Reports provide insights and analysis on the outcomes of Licence Appeal Tribunal (LAT) and court decisions.
Customize success rate reports on any variable relating to disputed AB claims captured in LAT and court decisions!
Decisions By Top 10 Insurers
*Sample Chart
Statistical Report fees are based on the complexity of your data request
Learn More & Get a Quote Here >
The Tribunal found:
-
- A May 2019 letter from Wildman’s nurse practitioner Ms. VanHoof indicated that Wildman’s inability to manage her ADLs and her reliance on others pre-dated the accident, and other medical records indicated that she was off work at the time of the accident due to ongoing chronic pain and concentration issues related to her 2006 and 2018 accidents, and had started psychotherapy regarding those accidents.
- Wildman’s physiotherapy and psychotherapy records included no treatment modifications following the subject accident.
- There was no evidence that Wildman suffered a concussion from the subject accident. She did not initially report hitting her head, and did not report any concussion symptoms at her follow-up visit a month later. The hospital records did not mention a head injury or headaches. Her family health team CNRs on January 10, 2020, noted that she was asymptomatic, with no bruising or palpable masses.
- Concussion symptoms were first indicated by her legal representatives on January 17, 2020, when they contacted the clinic regarding an OCF-3 and inquired whether she had exacerbated her pre-existing head injury. Following that call, she visited the clinic and reported that she hit her head on the headrest in the accident and now suffered from frontal headaches and right ear pain. She was then diagnosed with a head injury and an exacerbation of concussion symptoms, which was found was not equivalent to sustaining a concussion.
- The nurse practitioner, Ms. VanHoof’s February 2020 OCF-3 concussion diagnosis, which was almost identical to the one produced for the April 2018 accident, was not afforded any weight. Further finding that Ms. VanHoof had a history of advocating for increased treatments for Wildman without a diagnosis as a basis. She had also written to the Applicant’s insurer following the 2018 accident, outlining his susceptibility to further concussions and implying this was the case, when there was no concussion diagnosis from that accident other than in her OCF-3.
- Wildman’s chronic pain and psychological injuries were not caused by the subject accident, but by her 2006 and 2018 accidents. There was no change in her care or presentation following the subject accident, and her condition had not deteriorated at a higher rate than before. At best, neuropsychologist Dr. Hamilton found an exacerbation of her pre-existing psychological issues, but clearly attributed her current presentation to the 2018 accident. There was virtually no mention of the subject accident in the psychotherapy records, which suggested it had no meaningful impact on her psychological state.
- “The funding for catastrophic impairment assessments is separate from and not calculated against the Applicants medical and rehabilitation benefit limits. As a result, I find that approving the assessments, subject to the funding limits for any one assessment, is not a concession regarding the characterization of the Applicant’s injuries. To me, the Respondent is exercising good faith adjusting by funding the catastrophic impairment assessments. Although, I note that it was likely unnecessary for the Respondent to fund the assessments in light of the other evidence, and the jurisprudence in Johnson v. Co-operators General Insurance Company, 2024 CanLII 49023 (ON LAT), which was released after submissions were made for this hearing. Moreover, the approval of funding for the catastrophic impairment assessments gives the Applicant the benefit of the doubt and the opportunity to explore the extent of her injuries from the subject accident. As assessments are speculative in nature, it is entirely possible that the report from the assessment finds that the Applicant’s injuries from the subject accident were minor and had no contribution to her current presentation.”
Our MIG Monday series discusses the multitude of factors to consider when evaluating a risk position on MIG cases. The Tribunal has ruled on the MIG in 33% of the decisions so far. Each case is nuanced, but with similar factors.
Inform your position & present persuasive arguments. Include an Outcome Analysis Report (OAR) in your case evaluation complete with For/Against cases. Get an OAR!