Contact Us

  MIG Update – May 11, 2026

Concussion – Clinical Diagnosis versus Imaging

This week’s MIG review examines a concussion case where the Tribunal considered the Applicant’s persistent, documented symptomatic reports against the Respondent’s reliance on a negative CT Scan. This case underscores how the consistency and continuity of complaints outweigh the absence of visible pathology. Ultimately, the Tribunal held that the absence of physical abnormalities on a Head CT (such as bleeds or fractures) does not negate a concussion finding.

Virtual Training – Upcoming Sessions

Secure your seat for inHEALTH’s 2026 upcoming Virtual Training sessions!

• SABS Expedited: May 25-29, 2026
• BI Fundamentals: June 15-19, 2026

*Eligible Participants receive 9 Substantive – CPD hours upon course completion

Course details & register here +

In Calado v. TD General Insurance Company ( 24-006357) , Renato Caldo was involved in an accident on October 15, 2021, and sought entitlement to various benefits. This review focuses on the MIG finding. He sought to be removed from the MIG based on a hairline fracture of the left wrist, a concussion, and psychological injuries.

Calado relied on the CNRs of St. Mary’s Emergency Hospital, the CNRs of GP Dr. Karaul, the March 2022 IE report of neurologist Dr. Desai, the April 2022 report of chiropractor Dr. Dixon, the November 2024 report of neurosurgeon Dr. Jha, the November 2024 report of chiropractor Dr. Shteynberg, and the October 2021 and February 2022 OCF-3s of physiotherapist Mr. Pandya.

Regarding the Treatment Plans, the Applicant submitted that the April 2022 concussion assessment Treatment Plan was reasonable and necessary given the findings of Dr. Dixon and the January 2022 CNRs of GP Dr. Karaul and GP Dr. Natarajan. . He argued that the psychological assessment Treatment Plan was warranted due to mild adjustment difficulties identified in the November 2024 report of Dr. Jha and the March 2022 IE report of Dr. Ladak. He relied on the November 2024 neurological assessment of Dr. Jha and the November 2024 concussion assessment of Dr. Shteynberg to support the April 2024 concussion and neurological assessment Treatment Plans.

TD submitted that Calado’s injuries consisted of soft tissue injuries that did not meet DSM-5 criteria for a formal diagnosis. It relied on the March 2022 IE reports of neurologist Dr. Desai, psychologist Dr. Ladak, and physiatrist Dr. Ko. Regarding the Treatment Plans it submitted that Calado failed to provide medical evidence to demonstrate that the concussion, driving, psychological, and neurological assessments were reasonable and necessary. It relied on the IE reports of Mr. Bullard, physiatrist Dr. Ko, psychologist Dr. Ladak, and neurologist Dr. Desai. It argued that the Applicant had not sought medical treatment since January 2022.

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:

• • The immediate medical record, noting that the diagnosis of “brain concussion” at St. Mary’s Emergency Hospital was reinforced by CNRs from the GP Dr. Karaul within the first three months post-accident, creating a consistent evidentiary trail of symptoms like photosensitivity and dizziness.
  • While there was the absence of physical abnormalities on a Head CT (such as bleeds or fractures) this did not negate the concussion finding, as the emergency records and ongoing symptomatic complaints provided sufficient clinical proof of the injury.
  • The concussion finding was further solidified by the neurological IE by Dr. Desai, whose assessment of a “low-grade concussion” five months post-accident aligned with Calado’s early clinical history and persistent reporting of photophobia and nausea.
  • The neurological assessment fees in the amount of $225.62 dated within three months of the referral from the doctor’s visit, and within six months after the accident with clearly defined diagnostic goals was reasonable.
  • The neurological assessment based on the specialized findings of Dr. Jha and Dr. Shteynberg was reasonable. However Calado failed to prove that a second neurological assessment 30 months post-accident was reasonable and necessary finding it was duplicative.

  ---

  Need a briefing on recent MIG trends or a case law training session for your team? We can help.

  Contact us today or reach out on live chat to set up a tailored session or request a stat report and summary of recent MIG rulings.

  ---