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  MIG Update – October 25, 2021

Psych Symptoms Are ‘Clinically Associated Sequelae’

This week a MIG hold case where the Tribunal references the Superintendent’s Guideline No. 01/14 namely, the Minor Injury Guideline to conclude psychological symptoms were clinically associated consequences of minor, soft tissue injuries, and should therefore be treated under the MIG’s treatment framework….

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Factor: Psychological Symptoms

Psych Symptoms Are ‘Clinically Associated Sequelae’– In Nguyen v. Wawanesa Mutual Insurance Company (19-007890), a February 14, 2017 accident, Nguyen claimed that he should not be subject to the MIG due to the exacerbation of a pre-existing injury to his low back, chronic neck and back pain as well as psychological injuries sustained in the accident.

With respect to the psychological injury, Nguyen relied on the Social Work Assessment Report of Ms. Amber Williams dated December 2, 2019, which mentions Nguyen’s reduced social activity, his trouble sleeping, caution while driving, decreased memory and concentration, irritability, fear, anxiety and diminished interest in activities he previously enjoyed.

Further Nguyen relies on a May 11, 2020 Independent Pain Medicine Assessment Report of anesthesiologist Dr. Hien Ta findings of disturbed sleep and vehiclular phobia and the fact that he was prescribed amitriptyline in October 2018 used to treat depression. It was Dr. Ta’s opinion that Nguyen’s anger, frustration and minor cognitive dysfunction should remove him from the Minor Injury Guideline.

The Tribunal concluded that Nguyen did not meet his burden of establishing proof that his pre-existing injuries or chronic pain remove him from the MIG.

On the psychological injury, the Tribunal found Nguyen’s symptoms to be clinically associated consequences of his minor soft tissue injuries that can be treated under the MIG treatment framework.

The Tribunal held:

• The Schedule’s definition of a minor injury does not include psychological impairment, the definition does however capture the “clinically associated sequelae” of minor, soft tissue injuries.
  
• The Minor Injury Guideline adopts a “functional restoration” framework for the treatment of minor injuries which contemplates “interventions that help the insured person to reduce or manage his/her pain and associated psycho-social symptoms.”
• The Guideline is clear that some psychosocial issues can be expected as the clinical consequences of minor, soft tissue injuries.
  
• While the family doctor prescribed an antidepressant, this was almost two years after the accident and there are no clinical notes and records documenting a link between the accident and any psychological impairment.

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