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  MIG Update – November 17, 2025

PTSD Diagnosis After 2 Year Delay Not Determinative

This week’s MIG case involves an Applicant who was 10 years old at the time of an April 2, 2020 accident. The Tribunal considered a lack of medical reporting regarding the psychological injury for two years after the accident and the reasoning for the delay…Is there a timeframe for symptom onset to qualify for a MIG escape?

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In Nielsen v. Economical Mutual Insurance Company (23-014525), The Applicant, at the time, aged 10 years old, was involved in an accident on April 2, 2020 and sought entitlement to three Treatment Plans for psychological assessment and services totaling $8,015.65. He submitted that he should be removed from the MIG as he suffered from post-traumatic stress disorder, somatoform disorder, anxiety, vehicular anxiety, depression, headaches, dizziness, and shoulder pain.

The Applicant relied on the clinical notes and records of his family doctor Nathwani and on Dr. Sharifzadeh’s assessment report dated September 2023 for the diagnosis of post-traumatic stress disorder (PTSD) and somatoform disorder, in-vehicle psychological fear, nervousness, and accident recollections and mild clinical depression. The Applicant also relied on the report of child and adolescent psychiatrist Dr. Vukovic dated May 2024, which noted recommendation for more psychotherapy sessions and a specialist for the applicant’s shoulder pain.

Economical challenged the Applicant’s claim, noting a lack of reports regarding the psychological injury for two years after the accident. Further that the constant presence of the Applicant’s mother during his interview with the s.25 assessor actively influenced the discussion and assessment.

Economical relied on the IE report of psychologist Dr. Harris, dated October 2023, and addendum report dated May 2024, which opined that the Applicant did not have any accident-related psychological impairments that would prevent him from achieving maximal recovery of his minor injury. Further Dr. Harris’ addendum opinion following the review of Dr. Sharifzadeh’s test results while noting that there is a slight elevation in the PTSD scale which he considered to be insignificant and suggested that it was not substantially incapacitating the Applicant.

In reply the Applicant submitted there is no set period within which symptoms must present to qualify for an exemption from the MIG, particularly in cases of minors. The lack of medical reporting prior to April 2022 was attributable to the age of the Applicant and his mother’s injuries.

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The Tribunal found:

• Dr. Nathwani’s notes in April 2022 linked the Applicant’s psychological condition to the accident when the Applicant conveyed ‘the accident happened to me too’. He described the accident, recounting his stress when his mother was unconscious and when he helped her because she could not walk. Further noting in August 2022, that he was having vehicular anxiety, as reported by his mother.
  
• “The applicant was referred by Dr. Nathwani for counselling at Lumenus Community Services. Part of the counselling as described by Shira Osher, child, adolescent, parent and family psychotherapist, dated February 19, 2023, focused on helping the applicant express his feelings following the accident and self reflection around the impact of the accident. Dr. Nathwani also referred the applicant to MGH Child Adolescent, Mental Health Outpatient due to his psychological symptoms. This was followed by referrals for psychological treatment at Michael Garon Hospital on June 21, 2022, February 13, 2023, and March 2, 2023.”
  
• Dr. Sharifzadeh, psychologist, assessment report dated September 14, 2023 diagnosed the Applicant with post-traumatic stress disorder (PTSD) and somatoform disorder under DSM-5 criteria. She opined that the Applicant experienced emotional and psychological difficulties following the accident, including in-vehicle fear, nervousness, and recurring memories of the incident. Dr. Sharifzadeh also noted that the applicant’s test results indicated mild clinical depression.
• As advanced by the Applicant, that there is no required timeframe for symptom onset to qualify for a MIG exemption, particularly for a minor, and that the delay in medical reporting reasonably explained by the applicant’s age and his mother’s injuries.
  
• “……and I am persuaded by the clinical notes from Dr. Nathwani that show that the applicant’s accident-related injuries were not addressed immediately following the accident but were subsequently identified and attributed to the accident. I also find that the slight elevation in PTSD scale noted by Dr. Harris is consistent with and supports Dr. Sharifzadeh’s diagnosis”.
• Economical’s submission regarding the mother’s influence was speculative and that it was not unusual for a parent to be present when a minor is being assessed.
• The Applicant was not subject to the MIG and entitled to the two Treatment Plans for psychological assessment and services totaling $5,815.65.

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