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  MIG Update – August 19, 2024

Post Concussive Syndrome Diagnosed in Telephone Interview

This week, a MIG escape on the basis of a concussion diagnosis where the Tribunal considered a letter submitted by a neurosurgeon that included a post concussive syndrome diagnosis following a telephone interview.

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Factor: Concussion

In Mckenzie v. Intact Insurance Company (20-014935), Delroy Mckenzie was involved in a motor vehicle accident on March 27, 2020, in addition to his claim for IRB, he sought entitlement to 10 OCF-18’s that included chiropractic treatment, psychological treatment, a post concussion syndrome workshop, and assessments for psychological, chiropractic, neurological, neuropsychological, OT, and neurocognitive.

Mckenzie submitted that he should not be subject to the MIG due to a diagnosis of a concussion as a result of the accident. He relied on a June 2020 letter from neurosurgeon, Dr. Neilank Jha, who diagnosed him with Post-Concussive Syndrome. Further, Dr. Jha’s December 2021 report confirmed the diagnosis and that he would require treatment outside of the MIG.

Mckenzie also relied on an April 2021 psychological assessment report that diagnosed him with Major Depressive Disorder, Somatic Symptom Disorder with Predominant Pain and Specific Phobia, Vehicular. Psychotherapy sessions were recommended, involving a combination of supportive cognitive and behavioural interventions.

Intact disputed Dr. Jha’s June 2020 letter because the assessment was conducted by telephone; and that the diagnosis was not supported by any other medical evidence. Further the subsequent CNRs of Ms. Debessai, Mckenzie’s nurse practitioner, did not refer to a concussion or concussion-related symptoms.

The Tribunal found:

• ‘Soon after the accident, on April 9, 2020, the applicant was referred to a neurosurgeon, Dr. Neilank Jha, by his nurse practitioner Betiel Debessai. Ms. Debessai noted in the referral “whiplash ?concussion. due to MVA” and that the applicant had reported dizziness and neck pain beginning 2 days after the accident.”
  
• Dr. Jha’s telephone interview with Mckenzie in June 2020 and subsequent letter noted reports of dizziness, pressure headaches, vision disturbances, fatigue and emotional disturbances. Dr. Jha diagnosed the applicant with a mild Traumatic Brain Injury as a result of the accident which had progressed to Post-Concussive Syndrome.
• Despite Intact’s argument that Dr. Jha’s diagnosis should not be considered as the assessment was conducted over the phone, a later report December 2021 was prepared following an in-person assessment. Dr. Jha confirmed his diagnosis of mild Traumatic Brain Injury – Post Concussive Syndrome which was sufficient medical evidence to establish the concussion diagnosis. Further noting there was a psychological component to the diagnosis.
• Intact did not advance any competing medical reports despite having dealt with a preliminary s44 non-compliance to which Mckenze ultimately agreed to attend and examinations were conducted.
• “I agree with the applicant and his cited case law that the Tribunal has consistently held that a concussion diagnosis falls outside of the definition of a “minor injury”. I find that the applicant has led sufficient medical evidence to support his claim for removal from the MIG on this ground….”

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