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  MIG Update – May 26, 2025



Insomnia a Pre-Existing Condition?

This week’s MIG escape case wherein the Tribunal considered the exacerbation of a pre-existing condition of insomnia. What evidence prevailed in this determination?

With 1700+ MIG decisions determined by the LAT so far… we provide research support that gives you answers.



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Factor: Pre-Existing Condition 

In Griffith Fyffe v. Belair Insurance Company Inc. (23-008316), Toni Jade Griffith Fyffe was injured in an accident on November 8, 2021 and she sought entitlement to four Treatment Plans for psychological services, psychological and psychiatric assessments totaling $9,955.76. In addition to her soft tissue injuries and diminished concentration she claimed that her pre-existing condition of insomnia was exacerbated as a result of the accident, and she should be removed from the MIG.

Griffith Fyffe relied on the records of Dr. Attia, her family doctor who diagnosed migraine headaches and sleep disorder in February of 2021 and in March 2021 prescribed propranolol and topiramate 25 mg and referred her for a sleep study. The records of Dr. Sabbagh dated November 2021 and January 2022 from the sleep clinic indicated mild obstructive sleep apnea and Griffith Fyffe herself indicated she had a significant increase in her insomnia following the accident.

Griffith Fyffe also submitted that since the accident she has been experiencing ongoing pain in her head, neck and upper back, as well as diminished concentration, low attention span, decreased memory and a reduced ability to focus. She relied on the psychological report of Dr. Toneatto dated May 2022 who indicated that denying her access to treatment would only exacerbate her current psychological and physical symptoms and lead to a more chronic clinical condition. He noted that her physical condition, anxiety and depression relative to her somatic concerns have deteriorated significantly.

Belair relied on the IE addendum report and opinion of psychologist Dr. Bacchiochi dated September 2022, who agreed that there was compelling evidence of pre-existing insomnia but opined it would not prevent maximal recovery from a psychological perspective.



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The Tribunal found:

      • The family doctor, Dr. Elham Attia’s diagnoses of migraine, headache, and sleep disorder along with the results of the sleep study by Dr. Sabbagh established the documented pre-existing condition.
      • The May 2022 psychological report of Dr. Toneatto was given significant weight; he conducted a comprehensive assessment including an initial screening interview and a thorough clinical assessment. He noted that her physical condition, anxiety and depression relative to her somatic concerns had deteriorated significantly and recommended cognitive behavioral therapy.
      • Although, Dr. Bacchiochi, in his s.44 Insurer’s Examination Paper Assessment addendum report dated September 8, 2022 opined that the pre-existing condition of insomnia from a psychological perspective would not prevent maximal recovery from her minor injury he did fee she would she would benefit from a course of cognitive behavioural therapy for insomnia.
      • “I am persuaded by the applicant’s medical evidence which tells a consistent story before the accident to November 8, 2021, when the accident occurred. I assign significant weight to the psychological report of Dr. Toneatto, which I find to be compelling medical evidence stating that the pre-existing condition precludes the applicant’s recovery in the MIG. In his report, Dr. Toneatto recommended 12 sessions of cognitive behaviour therapy. Similarly, Dr. Bacchiochi, also advised that the applicant would benefit from cognitive therapy.”
      • Given the consistent complaints of exacerbation of her insomnia since the accident “she no longer had minor injuries, but rather significant impairment that precluded recovery.”

    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 33% 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. Get an OAR!

     

Archive of LAT Updates

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

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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

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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

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

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

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

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April 16, 2025: Deficient Notice Renders NEB Payable

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April 14, 2025: MIG Valid Medical Reason

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

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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

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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

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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

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March 10, 2025: Res Judicata Waived on New Evidence

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

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

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

NEB

February 24, 2025: Doctor Not Required to Provide Diagnosis

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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

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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

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

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

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

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

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

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

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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

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

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November 11, 2024: GP Concussion Diagnosis Accepted as Legitimate

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

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November 4, 2024: Submissions Do Not = Evidence

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