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  MIG Update – July 20, 2026

Early Concussion Diagnoses Prevail vs Late IEs

This week, we review a concussion case where the Tribunal prioritized contemporaneous medical records where the treating doctors observed immediate symptoms and initiated treatment referrals over the Respondent’s challenge to the Applicant’s history and reliance on IEs obtained nearly two years post-accident.

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Factor – Late Stage IEs

In Srouji v. Definity Insurance Company (24-014827) Magdeline Srouji was involved in an accident on December 11, 2023. She sought removal from the MIG based on a concussion diagnosis and entitlement to one Treatment Plan for physiotherapy services totaling $1,188.70.

Srouji’s Position:

Srouji submitted that she sustained a concussion after a T-bone impact caused her head to strike and shatter the driver’s side window. She relied on emergency department clinician Dr. Meyer’s December 2023 records, which documented striking the left side of her head along with symptoms of headache, photosensitivity, dizziness, and nausea, noting a diagnosis of post-concussive syndrome and referrals for an MRI and a concussion clinic. She further relied on GP Dr. Mourcos’ December 2023 CNRs, which assessed a post-MVA concussion and noted left scalp tenderness. She also pointed to GP Dr. El Shatshat’s March 2024 walk-in clinic notes diagnosing a concussion, anxiety, and light sensitivity, as well as RMT records from October 2024 to April 2025 documenting anxiety, brain fog, and dizziness.

Definity’sPosition:

Definity maintained the accident was a minor parking lot impact with no airbag deployment. It pointed to the objective ER findings of normal cognitive triage, intact reflexes/coordination, a clear head CT scan, and a normal spinal X-ray. It argued the concussion diagnosis rested entirely on subjective self-reporting and highlighted pre-existing conditions (keratoconus, a progressive eye disease and prior concussions) and heavy marijuana use. It relied on neurologist Dr. McLachlan’s September 2025 IE report, which concluded Srouji did not suffer a concussion due to the minor impact and absence of immediate signs (loss of consciousness, amnesia, or confusion). General physician Dr. Khaled’s August 2025 IE report noted Srouji returned to full-time work duties on December 21, 2023.

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The Tribunal found:

• • Prioritized the initial emergency room assessment (Dr. Meyer) and family doctor notes (Dr. Mourcos) over late-stage 2025 IEs. Further that a contemporaneous diagnosis that consisted of immediate symptom reporting, active treating diagnoses, and prompt referrals carried far greater probative weight than the IE opinions obtained long after the accident.
  • The family physician was aware of Srouji’s prior 2022 concussion but explicitly attributed the new concussion symptoms to the subject MVA.
  • The Section 44 neurological report was generated after the LAT application was filed and served shortly before written submissions were due which limited Srouji’s ability to respond.
  • “The respondent’s reliance on the applicant not pursuing the concussion clinic referral from the emergency department do not negate those early treating diagnoses. Further, Dr. McLachlan’s opinion that concussion symptoms typically improve over time supports rather than undermines the relevance and probative weight of an early diagnosis for removal from the MIG”.

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