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  MIG Update – November 3, 2025

Concussion Diagnosis Overcomes Two-Year Gap

This week’s MIG review involves a concussion case where the Applicant was not diagnosed with a concussion directly following the accident. The Tribunal considered the initial injury mechanics and the consistent reporting of symptoms in the intervening period.

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In Savytskyi v. Intact Insurance Company (23-012772), Vladyslav Savytskyi was involved in an accident on October 29, 2021, and sought entitlement to ACBs ongoing from October 29, 2021, and to six Treatment Plans for physiotherapy, chiropractic, and OT services, and in-home, ergonomic, and psychological assessments, totalling $13,108.95. He sought to be removed from the MIG based on a concussion.

Savytskyi was a pedestrian during the accident and fell after he was hit, striking his head, which resulted in a two-centimetre laceration to his scalp that required staples. He relied on the ambulance call report, hospital record, and CNRs. He also relied on the CNRs of Dr. Azzam, who diagnosed him with post-concussive headaches in June 2023.

Intact relied on IE reports of GP Dr. Kopyto and psychologist Dr. Bacchiochi, who determined that Savytskyi did not sustain any physical or psychological impairments that fell outside of the MIG. It maintained that there was almost a two-year gap before Dr. Azzam’s diagnosis of post-concussion headaches. It relied on OT Jung’s October 2022 Form 1 and report concluding no ACBs were required.

The focus of this review is on the MIG/Concussion analysis.

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The Tribunal found:

• The ambulance call report and hospital record confirmed that Savytskyi sustained a head injury, evidenced by a scalp laceration requiring staples.
  
• “…. a note of Cambridge Centre for Health and Wellness dated November 16, 2021 (two-weeks post-accident) notes that the applicant experienced headaches every day for the last week. The CNRs of Myers Physiotherapy also support that he reported complaints consistent with a concussion. For example, a note dated January 15, 2022, states “head injury – headaches – aggravating factors to sit to stand, noise, light and fast movement.” These CNRs reference off and on complaints about headaches up until October 17, 2022, which is the last note in the record. For these reasons, I accept Dr. Azzam’s diagnosis of post-concussive headaches in June 2023. I also find this diagnosis consistent with the mechanics of the accident because the applicant sustained a head injury which required staples.”
  
• Savytskyi reported experiencing post-concussion symptoms to OT Agro which was also consistent with his scores on the Rivermead Post-Concussion Symptoms Questionnaire. Further that his self-reports of post-concussive symptoms were credible, finding him honest and did not appear to exaggerate, having returned to his factory job shortly after the accident and being independent with self-care.
• The IE assessors do not address whether Savytskyi sustained a concussion as a result of the accident. Dr. Kopyto’s IEs heavily focussed on Savytskyi’s physical impairments, whereas Dr. Bacchiochi’s role was to assess whether Savytskyi sustained any psychological impairments.
  
• ‘Although I acknowledge that the applicant was not diagnosed with a concussion directly following the accident, I find the evidence supports that he sustained a head injury as a result of the accident and complained of post-concussion symptoms two weeks following the accident. He also made regular complaints to his treating clinic regarding same. For these reasons, I find the applicant has met his onus in proving on a balance of probabilities that he sustained a concussion as a result of the accident which removes him from the MIG…”

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