MIG Update – November 29, 2021
Family Doctor Diagnosed Anxiety – Does Not Require Psychological Assessment
In this week’s case the Tribunal took matters into their own hands in making the case on behalf of the Applicant. Interestingly, a MIG escape where the family doctor diagnosed anxiety and that a psychological assessment was not required to confirm the diagnosis and begin treatment.
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Psychological Diagnosis by Family Doctor
MIG Escape: In Strouble v. Unifund ( 20-008204), Daniel Strouble injured in a September 9, 2019 accident was seeking chiropractic treatment, psychological and orthopedic assessments submitting he continued to seek treatment 2 years post accident. The Tribunal quickly pointed out that this was not the test to escape the MIG.
Strouble’s submissions were silent on whether a pre-existing, psych or chronic pain condition was what he was relying upon to demonstrate entitlement beyond the MIG. The Tribunal undertook a review of all the evidence submitted finding the diagnosis of anxiety rendered by Strouble’s GP is what entitled him to treatment beyond the MIG. However, the psychological assessment was not allowed.
The Tribunal held:
- The CNR’s of the family doctor showed Strouble was complaining of anxiety and depression at his first visit post-accident on September 14, 2019.
- The CNR’s showed a diagnosis of anxiety as result of the accident, coping strategies were provided and a referral for psychotherapy 8 months later on May 27, 2020. The consultation request noted Strouble was irritable, lacked motivation and was feeling low and worthless.
- The S.44 by Dr. Mandel dated August 14, 2020 was given limited weight – Dr. Mandel refers to a “substantial” psychological impairment which Strouble is not required to prove in order to access treatment outside of the MIG limits.
- “On Dr. Atwal’s CNRs alone, I find that the applicant sustained a psychological impairment as a result of the accident. The applicant has shown that not only was he complaining of psychological symptoms, but that Dr. Atwal provided a diagnosis and additionally referred him for further psychotherapy treatment. For these reasons, I find that the applicant is entitled to treatment outside of the MIG on the basis of a psychological impairment”
- The proposed s25 psychological assessment submitted November 2019 proceeded 7 months later in June 2020. The resulting report and diagnosis was completed by a registered psychotherapist supervised by Dr. Keeling. The nature of the supervision was unclear as well as who ultimately made the psych diagnosis.
- By the time the s25 assessment was undertaken Strouble had already been diagnosed with anxiety as result of the accident by his family doctor and had a referral for psychotherapy on May 27, 2020 without the necessity of a psychological assessment.
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