MIG Update – October 2, 2023
‘IE’ Does Not Establish Causation
This week, a MIG escape case, where the Tribunal considered whether a shoulder injury was caused by the subject accident or was an evolution of a pre-existing injury.
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?
In Sarsonas v. Cooperators General Insurance Co., (20-002765), Norman Sarsonas involved in an automobile accident on July 2, 2018 submitted he sustained an injury to his left shoulder in the accident that resulted in functional limitations and pain which became chronic in nature. He sought entitlement to 7 chiropractic treatment from March to December 2019 totalling $10,000 and a physiatry assessment.
Co-operators disagreed that the accident caused the left shoulder injury relying on a June 28, 2021 opinion from Dr. Aldridge, general practitioner who noted that Sarsonas had previously been diagnosed with tendinitis of his shoulder in September 2012 and had reported left shoulder numbness to his family doctor in March 2017. Concluding that Sarsonas’ left shoulder pain symptoms and evolution of the left shoulder injury was not accident related given his occupational duties of repetitive bilateral shoulder movements.
Co-operators additionally relied on the IE reports of Dr. Dharamshi, general practitioner, dated June 27, 2019, January 29, 2020, February 21, 2020 and April 29, 2020, wherein he found that Sarsonas’ injuries were soft tissue in nature and that he reached reached maximal medical recovery and that no further treatment or rehabilitation services were required.
Sarsonas relied on the records of his family doctor, Dr. Deceana, reports of Dr. Nathaniel Dostrovsky, rheumatologist dated May 21, 2019, Dr. Yen-Fu Chen, physiatrist dated August 24, 2020 and the records of North Toronto Rehabilitation (NTR).
The Tribunal found:
- A diagnosis of chronic pain syndrome is not required to remove Sarsonas from the MIG. Saronas’ impaired functionality and pain limitation was clearly found in the medical evidence.
- “An August 21, 2018 entry from NTR notes Sarasonas’ left arm felt numb and “suspected impact left shoulder.” An October 3, 2018 entry states: “left shoulder is getting worse. Left supraspinatus . . .”
- Dr. Aldridge’s report, which was completed about 35 months after the accident was not convincing when weighed against the family doctor’s records and the report of Dr. Chen who opined that the pain impairments were directly caused or made worse by the accident.
- “Notably, Dr. Aldridge states that, given the accident occurred 35 months prior to his examination of the applicant, he is unable to comment as to whether the applicant suffers from a predominantly minor injury”.
- The opinion of “Dr. Dharamshi, in his four reports makes no assertion that the left shoulder injury is not the result of the motor vehicle accident. Instead, he states the applicant’s accident-related impairments include left shoulder strain with pain and reduction in range of motion, and further that there is no compelling evidence of any pre-existing medical condition.”
- “The medical evidence of left shoulder pain after the accident is robust and I am persuaded that the motor vehicle accident is the cause of the impairment.”
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 14 day free trial below to experience the service and see how it can help guide your decision making.