MIG Update – June 16, 2025
Does a Virtual Psych Diagnosis Hold Up?
This week, a MIG escape where the Tribunal considered whether a psychological diagnosis rendered in a virtual assessment with limited review of the medical evidence outweighed the evidence of a physiatrist?
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Factor: Virtual Assessment
In Carrascal v. Allstate (23-004855), Jean Carrascal was involved in an accident on April 14, 2021 and sought removal from the MIG on the basis of a psychological impairment and entitlement to four Treatment Plans for physiotherapy, psychological assessment and services totaling $11,692.11.
She relied on the diagnosis of Specific Phobia: Situational: Vehicular and Somatic Symptom Disorder with Predominant Pain: Moderate rendered by psychological associate Ms. Grinberg in an assessment dated October 2021 and the CNR’s of her family doctor Dr. Decena to support her claims.
Allstate submitted the IE report by physiatrist Dr. Devlin dated August 2021, indicated Carrascal’s injuries were minor in nature. Further Dr. Devlin opined that the disputed physiotherapy Plans were not reasonable and necessary since Carrascal’s soft tissue injuries would typically resolve in the three-to-six-month timeframe. On the psychological diagnosis they argued the report of Ms. Grinberg and diagnosis should be given limited weight as she performed a limited document review and did not see Carrascal in person.
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The Tribunal found:
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- The CNRs of Dr. Decena noted that Carrascal reported feeling nervous and was afraid to drive. He also recommended physiotherapy.
- Although, that there was no evidence that psychological associate Ms. Grinberg conducted a thorough document review as part of her assessment, weight was given to her report because it was supported by the contemporaneous CNRs of Dr. Decena.
- The fact that the assessment was done virtually in compliance with COVID-19 guidelines did not diminish its weight.
- The IE opinion of the physiatrist Dr. Devlin’s was not afforded any weight because as a physiatrist he was focussed on the physical injuries and did not perform any psychological testing. As such Carrascal was removed from the MIG and entitled to the two Treatment Plans for psychological assessment and services totalling $6,998.77.
- Carrascal was also entitled to the two Treatment Plans for physiotherapy services totaling $4,693.34, as the Plans were submitted within the scope of time Dr. Devlin noted was required for her physical injuries to heal. Moreover, Dr. Decena and walk-in clinic physician Dr. Drakhshan both recommended that Carrascal should partake in physiotherapy.
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