MIG Update – March 21, 2022
Failure To Test for Anxiety Critical Error
In the MIG escape reviewed this week, the Tribunal found the validity tests administered by the Respondent’s assessor did not measure or test for depression and anxiety which was the diagnosis made by the Applicant’s assessor. What were the differences in the tests administered that led to the Tribunal’s conclusion?
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Factor: Insurer’s Examination – Failure to Test for Anxiety
In Lechumanan v. The Co-operators General Insurance Company (20-006035), a June 28, 2018 accident, Lecuhumanan sought removal from the MIG due to a psychological impairment.
On Lechumanan’s behalf Dr. Harinder Mrahar, psychologist submitted a report September 3, 2018 with a diagnosis of depressive episode and an adjustment disorder (with anxiety).
Following a clinical interview and administration of several psychometric tests Dr. Mrahar reported:
- Beck Depression Inventory-II (BDI-II) and the Beck Anxiety Inventory (BAI) questionnaire scores indicated a moderate range of depression and a severe range of anxiety.
- The Pain Patient Profile was in the average range for depression and anxiety and in the above average range for somatic problems when compared to other pain patients.
- On April 17, 2019 the Beck Depression & Anxiety Inventories were repeated for a progress report with scores falling within the mild range on the BDI-II for depression and on the severe level on the BAI for anxiety.
The Co-operators relied on an October 15, 2018 psych (IE) by Dr. Gerald Dancyger, psychologist who concluded that the information obtained during the clinical interview and psychological test results did not reveal a substantial psychological impairment as a result of the accident. Dr. Dancyger reported:
- The scores on the testing provided to Lechumanan were invalid such that his test results could not be interpreted
- The test scores on the Personality Assessment Inventory (PAI) were invalid.
- The results of the Structured Inventory of Malingered Symptomatology (SIMS) test showed a significant degree of symptom exaggeration.
- Green’s Non-Verbal Medical Symptom Validity Test (NV-MSVT) showed poor effort and an exaggeration of cognitive difficulties.
- Lechumanan stated he was emotionally “okay” despite reporting issues with fatigue due to poor sleep
The Tribunal held:
- Greater weight on Dr. Mrahar report and diagnosis for the following reasons:
- The tests administered by Dr. Dancyger do not measure or test for anxiety and/or depression.
- “The PAI test “attempts to understand an individual’s personality traits and characteristics,”
- The SIMS test is used for the detection of malingering across a variety of clinical and forensic settings
- The NV-MSVT is used as an objective measure of symptom validity.
- “Simply put, one will not find an impairment if one does not test for it.”
- Dr. Dancyger fails to reconcile the significant weight put on Lechumanan self-report that he was ‘emotionally okay’ to his own opinion that Lechumanan test results suggest that he exaggerated his complaints and that he “can distort his clinical presentation.”
- Dr. Mrahar tests administered on two occasions were more consistent with Lechumanan’s report to his family doctor of sleep difficulties, waking up worried and feeling down.
- Lechumanan’s psychological complaints were not clinically associated sequelae to his minor injuries as advanced by The Co-operators
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