MIG Update – April 8, 2024

Psychiatric Diagnosis Prevails over Psychological Opinion

This week, a MIG escape where the Tribunal considered the Applicant’s family doctor’s psychiatric referral and its relationship to the accident in question. The proximity of the assessment dates and consistency of opinions were found compelling in this determination.

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Factor: PTSD

In Lo v. TD General Insurance Company, (22-002917), Lincoln Lo was involved in a motor vehicle accident on July 13, 2019 and claimed entitlement to two Treatment Plans for psychological services and assessment totalling $6181.88. He claimed that he should be removed from the MIG due to psychological impairment.

In support of his claim, Lo relied on a number of records and reports. First, the CNR’s of Dr. Saini, family physician, who made a referral to psychiatry due to severe depression with suicidal thoughts. The records from the Ottawa General Hospital dated April 22, 2020 which noted features of PTSD, with Lo claiming his life was turned upside down since the subject accident with the car exploding being a major event, including an overnight admission with a diagnosis of depression and suicidal ideation.

Lastly, Lo relied on the psychological assessment report by Mandy Fang, registered psychotherapist, supervised by Dr. Sharleen McDowell, psychologist, dated May 28, 2020 who diagnosed him with PTSD, Major Depressive Disorder and somatic symptom disorder supported by the trauma of the accident.

TD disagreed, arguing that Lo did not provide any compelling medical evidence. Their view of Dr. Gardner’s report is that he referenced Lo’s anxiety and depression as regarding society and COVID-19, in addition to the accident. The IE report of psychologist Dr. Nemeth dated January 2022 opined that Lo’s psychological state met the criteria of a minor injury, as there was no data reflecting the presence of psychological symptomatology. Further Lo indicated on multiple occasions that he did not have a desire for psychological-related treatment, specifically,a note dated October 2021, when he refused to be referred to a psychotherapist.

The Tribunal found:

• • • Dr. Saini, family physician, referral to psychiatry due to severe depression with suicidal thoughts along with the records from Ottawa General noting Lo’s report that his life was turned upside down since the subject accident and car exploding and an overnight admission for depression and suicidal thoughts was compelling evidence.
    • The corroborating evidence and opinions of all of Lo’s practitioners that diagnosed him with PTSD, depression, and somatic symptom disorder as a result of the accident.
    • Lo did provide compelling evidence that demonstrated his psychological impairment warrants treatment beyond the MIG.
    • The Insurer’s Examination report of Dr. Nemeth on the other hand was inconsistent with the bulk of the medical evidence presented by Lo.

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