MIG Update – May 15, 2023
Ongoing Symptoms of PTSD Corroborated by IE 2 Years Post Accident
This week, a MIG escape, the Tribunal considered the applicant’s self-report of ongoing symptoms of PTSD and anxiety that was documented over a course of two years and corroborated by the insurer’s own evidence.
The LAT released Performance Stats up to mid-year 7 which is current through to the end of September 2022. Together with the LAT’s last update we can now provide a comparison of year over year, with projections through to the end of year 7 in this annual update. What difference did a year make?
Factor: Ongoing Symptoms of PTSD and Anxiety
In Mak v. Economical Mutual Insurance Company (21-000281), Suet Man Mak was injured in an accident on April 6, 2019, and sought entitlement to a psychological assessment and physiotherapy services beyond the MIG limit.
Mak relied on the CNRs of her family physician Dr. Ng, which she contended establish her Post-Traumatic Stress Disorder (“PTSD”), sleep difficulties and anxiety. Additionally Mak relied on a pre-screen report (March 2020) and psychological assessment conducted by Dr. McDowell (October 2021) who diagnosed her with Major Depressive Disorder with Anxious Distress and Specific Phobia (Travel).
Economical contended that Mak sustained only temporary mild emotional sequelae as a result of the accident, and relied on its IE assessment where Dr. Day found that Mak did not meet the diagnostic criteria for a mood disorder or PTSD.
Economical further argued that Mak’s s.25 assessment should be given little weight, on the basis that the CNRs of the family physician were not reviewed and that the assessment was conducted by Ms. Fang, a social worker/psychotherapist, as opposed to Dr. McDowall.
The Tribunal found:
- Dr. Ng noted soon after the accident that Mak was reporting symptoms of PTSD and anxiety. Further one year later Mak still was not sleeping well, and Dr. Ng queried whether she was suffering from PTSD.
- The March 4, 2020 pre-screen by Dr. McDowell noted Mak was exhibiting symptoms including racing and intrusive thoughts, nightmares, difficulties sleeping, avoidance behaviour, and flashbacks.
- “Although I agree with the respondent’s submissions that the s. 25 assessment was conducted by Mandy Fang, under the supervision of Dr. McDowell, I find that the diagnoses of Major Depressive Disorder with Anxious Distress and Specific Phobia Travel are consistent with the applicant’s ongoing reports of anxiety, difficulty sleeping, nightmares and fear of driving post-accident”.
- Around the time of the Fang/McDowell report in October 2021 Mak independently sought psychological treatment outside of the accident benefits system.
- Mak’s medical evidence was corroborated by Econcomical’s IE Assessment by Dr. Day that found Mak was still exhibiting psychological symptoms and distress two years post-accident and developed fear/avoidance of driving after the accident.
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