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  MIG Update – July 21, 2025



Provisional PTSD Diagnosis Suffices for MIG Escape

This week we review a MIG escape case involving an alleged psychological injury, with the Tribunal considering the Applicant’s evidence indicating a possible diagnosis of Post-Traumatic Stress Disorder (PTSD), in contrast to the Respondent’s Independent Examiner (IE) who provided a provisional PTSD diagnosis. The Tribunal held that the Applicant’s possible diagnosis was sufficient to establish that a genuine issue existed, warranting further investigation. As such, the Tribunal found that the psychological assessment sought by the Applicant was both reasonable and necessary under the circumstances.



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In
Banton v. Belair (23-003259), Damian Banton was injured in an accident on February 1, 2020 and sought entitlement to three Treatment Plans for physiotherapy services, a chronic pain and a psychological assessment, totalling $5,928.10. Having exhausted the $3500 MIG limit he sought removal from the MIG based on a pre-existing (chronic low back pain) condition, a psychological impairment, and a chronic pain diagnosis.

Banton directed the Tribunal to the May 2021 CNRs of family physician Dr. Cheung, that confirmed reported nightmares, anxiety, and sleeping difficulties, and assessed anxiety and possible PTSD. Further that Dr. Cheung suggested a treatment plan of related therapy and medication. He also relied on the psychologist Dr. Direnfeld’s June 2021 IE report, which endorsed symptoms for a provisional PTSD diagnosis.

Belair argued there was no compelling medical evidence documenting a pre-existing condition. Further that Dr. Direnfeld’s June 2021 IE report did not endorse sufficient clinically significant symptoms for a DSM-5 diagnosis of PTSD, and that Dr. Cheung’s CNRs did not mention possible PTSD until May 2021, 14 months after the accident. It also highlighted that Banton replied “no” when Dr. Direnfeld asked if he needed psychological treatment.



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The Tribunal found:

  • The family physician Dr. Cheung’s May 2021 assessment of Banton’s anxiety and possible PTSD compelling, as it was corroborated by psychologist Dr. Direnfeld’s June 2021 IE report, which endorsed symptoms for a provisional PTSD diagnosis and noted consistency with DSM-5 Criterion A for PTSD.
  • Dr. Direnfeld also stated Banton “had endorsed the most severe or second most severe option for each of the 20 symptoms on the PTSD Checklist for DSM-5 (PCL-5). On the Beck Anxiety Inventory, the applicant exhibited low levels of anxiety, and on the Beck Depression Inventory II, the applicant scored in the range for moderate symptoms of depression. Scores on the Work and Social Adjustment Scale between 10 and 20 suggest significant functional impairment. The applicant scored 15 on this questionnaire.”
  • As for Banton’s response when asked if he needed psychological treatment for anxiety, Dr. Direnfeld noted that inappropriate responses or inconsistent responses were possibly attributable to attempts at impression management.
  • The treatment plan for the psychological assessment submitted October 2022 was reasonable and necessary as Banton “provided sufficient compelling evidence indicating there are grounds on which to believe a condition exists, such that further investigation is warranted. The CNRs of Dr. Cheung, to which I am pointed, note sleeping difficulties, nightmares, and anxiety.”

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Archive of LAT Updates

July 21, 2025: Provisional PTSD Diagnosis Suffices for MIG Escape

MIG

June 4, 2025: MIG Escape Justifies CAT Assessments

CAT, MIG

June 2, 2025: Late Onset (Two Years) Shoulder Pain Remains in MIG

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May 28, 2025: CRA Records not Necessarily Determinative Absent Corroborating Documentation

IRB

May 26, 2025: Insomnia a Pre-Existing Condition

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May 16, 2025: First Year of Self Employment Results in $Nil IRB Despite Demonstrated Earnings

IRB

May 12, 2025: Res Judicata Not Waived For New MIG Hearing

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April 30, 2025: Tribunal Confirms Four Class 4 Marked Impairments

CAT

April 28, 2025: MIG Not Conceded Despite Approved CAT Assessments

MIG

April 23, 2025: Court Reverses Tribunal’s Unreasonable Adjournment Refusal

Adjournment, CAT, Divisional Court

April 21, 2025: MIG Escape on Fractured Tooth 15 Months Later

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April 16, 2025: Deficient Notice Renders NEB Payable

NEB

April 14, 2025: MIG Valid Medical Reason

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April 9, 2025: Bus Travelling Over Elevated Manhole Cover Satisfies “Collision”

Definition Accident

April 7, 2025: Four OCF 18’s Payable Despite MIG Hold

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March 26, 2025: Post 104 IRB Ongoing for Non-CAT

CAT, IRB

March 24, 2025: 30% Award for Failure to Review CNRs Overturned on Reconsideration

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March 19, 2025: Yes to CAT, No to Post 104 IRB

CAT, IRB

March 17, 2025: Imaging Report Alone Insufficient to Establish Causation

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March 12, 2025: Tribunal Rules Again on Matter Referred Back by the Court

Definition Accident, Divisional Court

March 10, 2025: Res Judicata Waived on New Evidence

MIG

March 5, 2025: No Criterion 8 CAT as Physical Pain the Limiting Factor

CAT

March 3, 2025: Cause of Shoulder Tear Degenerative or MVA Related?

MIG

February 26, 2025: NEB Payable to 104 Week Mark Due to Technical Breaches

NEB

February 24, 2025: Doctor Not Required to Provide Diagnosis

MIG

February 19, 2025: Court Sets Aside Tribunal S.32 Notice Decision

Breaking News, Div Court, Limitation Period

February 12, 2025: Post 104 IRB Despite Employment & No CAT As Only Two Marked Impairments

CAT, IRB

February 10, 2025: GP Evidence Preferred over IE Regarding Concussion

MIG

February 5, 2025: No Election Required Despite Endorsement of IRB & NEB

Procedure, SABS

January 27, 2025: CNR’s + Imaging Determinative of Complete Shoulder Tear

MIG

January 22, 2025: Court of Appeal Upholds Divisional Court Decision

Divisional Court, NEB, Reconsideration

January 20, 2025: GP’s Diagnosis of “Head Injury” Prevails

MIG

January 15, 2025: Tribunal Accepts Neither Expert in Awarding Pre But Not Post 104 IRB

IRB

January 13, 2025: A Brain Contusion is Not Enough for a Concussion Diagnosis

MIG

January 9, 2025: Court Awards $69K in Costs for Apparent Miscarriage of Justice

Divisional Court,Costs

January 6, 2025: Corroborative Evidence Not Necessarily Required in Psych Diagnoses

MIG

December 18, 2024: Applicant Successful in CAT Case Where Respondent’s Expert Unavailable

CAT

December 16, 2024: Applicants Lose on Flawed Interpretation of the Schedule

MIG

December 11, 2024: Court Sends Paraplegic Matter Back to Tribunal re “Accident”

Definition Accident, Divisional Court, Reconsiderations

December 9, 2024: Pre-Existing Conditions MIG Escapes?

MIG

December 4, 2024: Court Remits $770K Award Worthy Matter Back to Tribunal

Award, Divisional Court, IRB

December 2, 2024: GP Questionnaire Does Not Trigger MIG Escape on Pre Existing

MIG

November 27, 2024: Court Remits $200K Award Worthy Matters Back to Tribunal

Award, Divisional Court, IRB

November 25, 2024: Pre-Screen Not Psychological Diagnosis

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November 20, 2024: IE Not Reasonable or Necessary – No to CAT & IRB

CAT, IRB, Procedure

November 18, 2024: No Evidence Pre-Existing Conditions Prevent MMR

MIG

November 13, 2024: Applicant’s Explanation for Delayed Application Found Reasonable

Procedure

November 11, 2024: GP Concussion Diagnosis Accepted as Legitimate

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November 6, 2024: Court Remits “Unsafe” Decision Back for Rehearing

CAT

November 4, 2024: Submissions Do Not = Evidence

MIG