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.

Advance your best case with an Outcome Analysis Report – Request an OAR through live chat!


Thank you for participating in the 3rd annual LAT Free Day! Receive 15% off all OAR packages from now until November 30, 2021!

Buy Now!

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.

If you Have Read This Far…

Our MIG Monday series discusses the multitude of factors to consider when evaluating a risk position on MIG cases. The Tribunal has ruled on the MIG in 24% of the decisions so far. Each case is nuanced, but with similar factors.

Inform your position & present persuasive arguments. Include an Outcome Analysis Report (OAR) in your case evaluation complete with For/Against cases. Need an OAR?


inHEALTH Keeps you LAT inFORMED With Access To:

1. LAT Compendium Database – a relational database of LAT and Divisional Court Decisions equipped with multiple search options, Smart Filters, and concise case summaries

2. Notifications: – weekly LAT inFORMER delivered to your inbox Wednesdays; Newly Added Decisions on Fridays and Breaking News as and when it happens

 3. Research Support: – inHEALTH’s Live Chat Experts for guided searches and technical inquiries.

Sign up for a 30 day free trial below to experience the service and see how it can help guide your decision making.

Contact Sales


Contact Support

Contact Us


11 Allstate Parkway Suite 203
Markham, Ontario
L3R 9T8

Follow Us On