MIG Update – September 27, 2021

Failure to Secure Addendum Evidence Costly

The MIG escape case reviewed this week involves additional supporting medical information that was available yet not provided to the Respondent’s assessor for a more comprehensive review and addendum. What caused the Respondent’s arguments to fail?

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Factor: Addendums

In Kolanski v TD Insurance Meloche Monnex (19-011756), a November 2017 accident, TD disputed two treatment plans submitted July 2018 a chiropractic plan for the treatment of migraines and memory issues as well as a psychological assessment to address cognitive issues and difficulties with life management.

TD relied on the opinion of a multi-disciplinary IE (chiropractic and psychological) in August and September 2018 that concluded Kolanski’s injuries were within the MIG. Kolanski presented evidence that showed she suffered a head injury and post-concussion syndrome as a result of the accident from the onset. Subsequent to the IE’s Kolanski provided CNR’s in March 2020 and August 2020 to further support that her injuries were not MIG.

MIG Escape – The Tribunal held:

• The respondent’s position that the Minor Injury Guideline applies to the applicant is untenable.
  
• Dr. Syty-Gold, family doctor, completed a Disability Certificate on November 9, 2017 that clearly identified a mild head injury and post-concussion syndrome among Kolanski’s accident related injuries
• TD submitted that Kolanski did not provide it with the records of her treating practitioners until some time in 2020. However, TD was provided with a Disability Certificate (OCF-3) completed by the family doctor on November 9, 2017 that clearly identifies a mild head injury and post-concussion syndrome.
• TD did have the opportunity to provide the records it received from Kolanski in March 2020 to its assessors and to secure addenda reports. That was not done.
• The Tribunal is left with expert evidence from TD that addresses only the Minor Injury Guideline issue, and not whether the disputed benefits meet the test for reasonableness and necessity under the Schedule

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