MIG Update – October 19, 2026
Lack of GP Reporting Not a Bar to MIG Escape
In this week’s edition, the Tribunal confirms that a lack of psychological complaints in a family doctor’s CNRs isn’t fatal if the Applicant reports symptoms consistently elsewhere and backs them up with strong diagnostic evidence. We examine how the Tribunal weighed competing Section 25 and 44 assessments, the impact of validity testing, and why insurers need a concrete, defensible rationale when challenging unreviewed medical records.
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Factor – Evolving Psychological Condition
In Caputo v. CAA Insurance Company (25-004885), Lisa Caputo was involved in an accident on June 17, 2024, and sought entitlement to five Treatment Plans for chiropractic and psychological services, and for psychological, attendant care, and chronic pain assessments totalling $13,175.64. She sought to be removed from the MIG based on a psychological impairment. The discussion that follows is limited to the psychological diagnosis.
The Applicant’s Position
Caputo relied on the CNRs of family doctor Dr. Langer, her prescription summary, and a March 2025 Report by psychologist Ms. Aghamohseni, who diagnosed Posttraumatic Stress Disorder (PTSD) and Major Depressive Disorder, recurrent, severe, with anxious distress. She submitted that psychologist Dr. Gooden’s August 2024 assessment and IE report should be given less weight because it was less current than Ms. Aghamohseni’s assessment. She submitted that clinical findings rationally connected to her impairments supported the Treatment Plans.
The Respondent’s Position
CAA relied on the August 2024 IE report by psychologist Dr. Gooden, to whom Caputo reported that she continued to work, socialize, and maintain personal care. Dr. Gooden noted no indication of loss of attention or concentration and found no diagnosable DSM-5 diagnosis. It submitted that Ms. Aghamohseni’s report should be given less weight because she did not review the CNRs of family doctor Dr. Langer or available IE reports. It submitted that the Applicant reported no psychological difficulties to Dr. Langer, received no referrals, and attended no psychological treatment.
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The Tribunal found:
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- Omission of psychological complaints in Dr. Langer’s CNRs did not undermine Caputo’s credibility, as her ongoing Wellbutrin prescriptions showed pre-existing treated symptoms, early GP visits focused on physical pain, and she consistently reported psychological issues to other assessors.
- Ms. Aghamohseni’s March 2025 assessment was preferred over Dr. Gooden’s August 2024 IE, finding Caputo’s condition evolved over the intervening seven months. While Dr. Gooden found no DSM diagnosis initially, her CAD test flagged a “Significant Clinical Risk” score (139) that ultimately materialized into full-blown PTSD and MDD by the time of Ms. Aghamohseni’s evaluation.
- Ms. Aghamohseni relied on objective and verified validity testing results (BDI-II score of 44; BAI score of 25). Both experts’ validity testing confirmed Caputo’s responses were reliable and free of symptom exaggeration.
- CAA’s challenge regarding Ms. Aghamohseni’s failure to review Dr. Langer’s CNRs or prior IEs, failed to show what specific information in those records would have altered her testing or clinical opinion.
- Caputo was not entitled to the August 2024 psychological assessment plan because entitlement depends strictly on contemporaneous evidence existing at submission; a later-obtained diagnosis cannot retroactively justify a prior plan lacking supporting evidence.
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- Omission of psychological complaints in Dr. Langer’s CNRs did not undermine Caputo’s credibility, as her ongoing Wellbutrin prescriptions showed pre-existing treated symptoms, early GP visits focused on physical pain, and she consistently reported psychological issues to other assessors.