Contact Us

  MIG Update – September 15, 2025

Tribunal Weighs In On Late Chronic Pain Report

This week, a MIG escape case where the Tribunal considered the key question of what happens when a Chronic Pain Report is served two months after the document exchange deadline set out in the Case Conference Report and Order (CCRO)? Despite the timing, did the report play a pivotal role in the outcome?

Virtual Training – *NEW* Upcoming Fall Sessions

Secure your seat for inHEALTH’s 2025 upcoming Virtual Training sessions!

• SABS Expedited: October 6-10, 2025
• BI Fundamentals: December 1-5, 2025

*Eligible Participants receive 9 Substantive – CPD hours upon course completion

Course details & register here +

In Alvin v. Certas Home and Auto Insurance Company (23-014486), Simon Alvin was involved in an accident on July 27, 2021 and sought entitlement to two Treatment Plans for physiotherapy services and psychological assessment totaling $5,370.72. He submitted that he should be removed from the MIG as he suffered from chronic pain.

Alvin submitted that the CNRs of family physician Dr. Park showed a history of repeated complaints of neck and chest pain. He further relied on the August 2024 chronic pain report by specialist Dr. Wong who made a diagnosis of chronic pain.

Certas for their part relied on the April 2023 physiatry IE opinion of Dr. Gwardjan who opined that Alvin was suffering primarily soft tissue injuries which do not merit removal from the MIG and also stated that Alvin already had the benefit of formal physical rehabilitation and had achieved maximum therapeutic benefit. It further submitted Alvin had not met three of the six criteria for a diagnosis of chronic pain set by the AMA Guides, and also argued Alvin did not regularly attend approved treatment.

Late Submission of Chronic Pain Report

Certas requested that the Tribunal not consider the August 2024 chronic pain report by Dr. Wong because it was authored and subsequently shared with the Respondent after the document exchange deadlines set out in the CCRO. It submitted that including the report would create prejudice, because the late exchange did not allow it the opportunity to obtain a responding addendum report.

The Tribunal acknowledged the report was prepared on August 16, 2024, and shared with Certas in September 2024, well after the June 30, 2025 submission deadline. However, exercised its discretion under Rule 9.3 of the LAT Rules to accept the late report finding that excluding it would unfairly prejudice Alvin more than its inclusion would harm Certas, agreeing with Alvin that Certas had an opportunity to respond by seeking an extension of time to respond but didn’t.

Get Your Stats Report!

inHEALTH’s Statistical Reports provide insights and analysis on the outcomes of Licence Appeal Tribunal (LAT) and court decisions.

Customize success rate reports on any variable relating to disputed AB claims captured in LAT and court decisions!

Decisions By Top 10 Insurers

*Sample Chart

Statistical Report fees are based on the complexity of your data request

Learn More & Get a Quote Here >

The Tribunal found:

• While not incorporated into the SABS, the Tribunal has found the AMA Guides as a valuable interpretive tool for assessing chronic pain claims in the absence of a diagnosis but that the Guides are only a tool.
• The August 2024 chronic pain report of Dr. Wong was compelling and persuasive as it provided a clear diagnosis of chronic pain as a result of the accident.
  
• Dr. Gwardjan’s April 2023 physiatry IE report did not address the issue of chronic pain, however, it listed specific pain in the base of the neck, and along the spine across the thoracolumbar segment, aggravated by general physical activities, particularly lifting/back bending.
• Alvin presented a convincing history of repeated complaints that were supported by his submissions which were found on the balance of probabilities, that he had demonstrated he was suffering from chronic pain with a functional impairment.
  

Need a briefing on recent MIG trends or a case law training session for your team? We can help.

Contact us today or reach out on live chat to set up a tailored session or request a stat report and summary of recent MIG rulings.