Print

 

  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.


 

Advance your best case with an Outcome Analysis Report – Request an OAR through live chat!

Request OAR


Factor: Causation

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?

 

Archive of LAT Updates

April 24, 2024: Wilful Misrepresentation Abounds on IRB Repayments

IRB

April 22, 2024: Records Alone Do Not Warrant MIG Removal on Pre-Existing

MIG

April 15, 2024: Demands of Child-birth Pre-Existing Condition?

MIG

April 10, 2024: Court Upholds Tribunal Decision That a MIG Removal is a Complete MIG Removal

Divisional Court, MIG

April 8, 2024: Psychiatric Diagnosis Prevails over Psychological Opinion

MIG

April 3, 2024: Court Sends Matter Back to Tribunal Concerning “Accident”

Definition Accident, Divisional Court

April 1, 2024: Ortho Opinion Prevails on Origins of a Fracture

MIG

March 27, 2024: Supreme Court Takes Issue with Tribunal, Divisional Court & Court of Appeal

Limitation Period, Reconsideration, Supreme Court

March 25, 2024: Expert’s Conclusory Statement Insufficient on Pre-existing Condition

MIG

March 20, 2024: Non-Compliance by Both Parties Impacts IRB and Medical Claims

IRB

March 18, 2024: No Weight Afforded to Handwritten Illegible CNR’s

MIG

March 13, 2024: Denials Deficient and Pain Relief Validates Treatment Plans

Treatment Plans

March 11, 2024: “Radicular Irritation” & MRI Findings Not MVA Related

MIG

March 6, 2024: Tribunal Upholds Decision Excluding Improperly Secured IEs From the Evidence

Evidence, IE, Reconsideration

March 4, 2024: Concussion and Chronic Pain Diagnoses Require Expertise

MIG

February 28, 2024: Prior Health Concerns Complicate Claim for CAT

CAT

February 26, 2024: Unchallenged Virtual Chronic Pain Assessment Accepted

MIG

February 21, 2024: Consent by Parties for Adjournment Not Determinative

Adjournment, Procedure

February 14, 2024: Tribunal Does Not Accept the CAT Findings of Either Party

CAT

February 12, 2024: MIG Escape on Concussion Diagnosis Despite Resolution of Symptoms

MIG

February 7, 2024: Financial Hardship Not A Defense for Repayment Responsibility

IRB

February 5, 2024: CT Scan of Wrist Fracture Contradicts Medical Opinion

MIG

January 29, 2024: Concussion Despite No Head Injury?

MIG

January 24, 2024: One Assessment Process Produces Two Discrete Reports

CAT, Productions

January 22, 2024: Defective Notices Do Not Trigger Limitation

MIG

January 17, 2024: Election Not Required, LAT Act Invoked & Limits Exhausted?

Award, Limitation Period

January 15, 2024: Chronic Pain Diagnosis Contradicted by Self-Reports

MIG

January 10, 2024: NEB Reinstated After Six Years Generates Award

Award, NEB

January 8, 2024: Undisputed Psychological Diagnosis Prevails

MIG

January 3, 2024: Significant & Competing Price of Non-Compliance for Both Parties

Non-Compliance

December 20, 2023 (Throwback Edition): Statutory Relief Within Tribunal’s Jurisdiction

Jurisdiction

December 18, 2023: ‘Incident’ of Viewing Video Not Use and Operation

MIG

December 13, 2023 (Throwback Edition): Employed Applicant Remains Entitled to Post 104 IRB

IRB

December 11, 2023: Chronic Pain Diagnosis In Absence of Physical Exam?

MIG

December 6, 2023: Four Marked Impairments for 2010 MVA

CAT

December 4, 2023: No Adverse Inference Drawn Despite Lack of pre MVA CNRs

MIG

November 29, 2023 (THROWBACK EDITION): 18 Month Delayed Notice Reasonable, However 7 Month Delay is Not

Limitation Period

November 27, 2023: Confirmed High Bar to Escape MIG on Pre-Existing

MIG

November 22, 2023: Multiple IEs Excluded From Evidence

IE, Evidence

November 20, 2023: Radiculopathy Complaint Requires a Diagnosis

MIG

November 15, 2023: Court Applies Tomec & CAT Decision Varied

CAT, Limitation Period

November 13, 2023: Insurer Expert Conclusion Inconsistent with Findings

MIG

November 8, 2023: Maximum Award in Excess of $60K on CAT Case

CAT

November 6, 2023: Medical Evidence Overrides Legal Referrals

MIG

November 1, 2023: Eighteen Month Delayed Notice Reasonable However Seven Month Delay is Not

Limitation Period

October 30, 2023: Which MVA Exacerbated Injuries?

MIG

October 25, 2023: Application Seeking CAT Determination an Abuse of Process

CAT

October 23, 2023: Functional Disability Despite 50 Hour Work Week

MIG

October 18, 2023: Statutory Relief Renders Equitable Remedy Moot

Div Court

October 16, 2023: Injuries Not Static - MIG Determined Again

MIG

October 11, 2023: CERB is Income However Not “Gross Employment Income”

IRB

October 4, 2023: Employed Applicant Remains Entitled to Post 104 IRB

IRB

October 2, 2023: ‘IE’ Does Not Establish Causation

MIG

Contact Sales

416.364.6688

Contact Support

Contact Us

InHealth

11 Allstate Parkway Suite 203
Markham, Ontario
L3R 9T8

Follow Us On