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  MIG Update – January 17, 2022

Psych Validity Testing Versus Disinterest in Treatment

In this week’s edition, the LAT scrutinizes similar validity testing results conducted 8 months apart by two psychological experts, with differing conclusions. The conclusions of the insurer’s expert included the Applicant’s statements of disinterest in treatment. What key elements of the test results did the LAT find persuasive in reaching their conclusion?

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Factor: Psych Validity Testing versus Disinterest in Treatment

In Lacroix v Wawanesa (20-004333), Lacroix was injured in an automobile accident on January 17, 2017 when a vehicle suddenly made a left hand turn striking his vehicle. Lacroix sought removal from the MIG based on accident related physical and psychological injury.

In February 2018 Dr. Pilowsky diagnosed Lacroix with major depressive disorder, single episode, moderate, post-traumatic stress disorder with vehicular anxiety, persistent, moderate, somatic symptom disorder with predominant pain. Dr. Pilowsky in concluding Lacroix’ impairment did not fit the MIG criteria recommended treatment to assist with more effective ways to cope and psychotherapy would be beneficial in treating Lacroix’s accident-related anxiety and depression.

Following this report, Lacroix sought psychological treatment out of pocket. As a result, Dr. MacDonald submitted a treatment plan in May 2018 for a further psychological assessment. He documented depressive episode, reaction to stress and adjustment disorders. In June 2018 this request was denied by Wawanesa on the basis of the MIG and that it was a duplication of service.

Wawanesa’s decision to deny Dr. Pilowsky’ s February 2018 treatment plan was ultimately based on the findings of their psychological IE conducted by Dr. Challis in October 2018. Wawanesa advised Lacroix based on a lack of diagnosis (not MIG) and his disinterest in treatment they would not approve the Pilowsky treatment plan. ​

The Tribunal held:

• • Both Dr. Challis and Dr. Pilowsky conducted interviews and administered psychological validity tests.. Both experts’ test results noted that Lacroix had a mild to moderate impairment which put into question the differing conclusions. 
  • Dr. Pilowsky test results showed elevated scores on the Beck Depression Inventory-II (“BDI-II”), the Beck Anxiety Inventory (“BAI”), Pain Catastrophizing Scale (“PCS”). 
  • Dr. Challis found Lacroix scored an overall moderate rating of depressive elements. As well as a valid profile scoring in anxiety, depression and somatization. However, Dr. Challis concludes the severity of findings were sub-clinical and do not warrant a diagnosis or treatment/investigations and the impairment was a minor injury. 
  • “Whereas, in Dr. Pilowsky’s opinion, these symptoms are outside of the MIG and require treatment. I accept Dr. Pilowsky’s conclusions as credible and supported by these similar test findings.” 
  • Lacroix indicated disinterest in treatment to Dr. Challis ‘I don’t think telling someone how I feel will help at all’. Conversely he did express interest in treatment to Dr. Pilowsky and that it needed to be close to his home. 
  • “The applicant is not expected to reliably self-diagnose the cause and possible treatment of his symptoms. While the applicant may have his reservations about psychological therapy, the test results of two accomplished psychologists indicate otherwise”. 
  • “It is not a concern to me that there is a duplication of services. I find that the applicant’s second psychological assessment demonstrates his concerns are legitimate and are genuinely affecting him, such that this second assessment will assist the applicant with his accident-related impairments.”

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.

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