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  MIG Update – September 23, 2024

Reliance on Symptom Magnification Test Proves Fatal

This week a MIG escape on the basis of psychological impairment. The mva in question occurred in 2019 with all relevant expert opinions provided proximate to one another a few months later. The Tribunal considered the psychological tests the experts selected and their resulting differing conclusions of the expert opinions in making its determination.

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Factor: Expert Opinion

In John v. Economical Insurance Company (21-014025) Stephon John was involved in a motor vehicle accident on March 2, 2019, and sought entitlement to five OCF-18s for chiropractic treatment, physiotherapy and orthopaedic and psychological assessments totaling $10,518.57. John claimed she sustained a psychological impairment and should not be held within the MIG.

John relied on the July 2019 opinion from psychologist, Ms. Aghamohseni, who concluded that John met the criteria for Major Depressive Disorder, Single Episode, Somatic Symptom Disorder and Specific Phobia, situational type, vehicular.

Economical argued that John’s injuries fell within the minor injury definition relying on two IE reports, one in August 2019 IE report of psychologist, Dr. Rubenstein who found no evidence that warranted any diagnosis according to DSM-IV. The second, an addendum in March 2020 also by Dr. Rubenstein who didn’t agree with Ms.Aghamohseni opinion because it was based on John’s self report.

The Tribunal found:

• • The report of psychologist Ms. Aghamohseni dated July 2019, which was comprehensive and persuasive and supported her conclusions of a psychological diagnosis under the DSM-V. She administered five psychological tests as follows:
    
  • Beck Depression Inventory–II (BDI-II); score of 46 – severe depression
  • Beck Anxiety Inventory (BAI): score of 32 – severe anxiety
  • Davidson Trauma Scale (DTS): difficulties ranging from “A little bit” to “Extremely”
  • Pain Patient Profile (P-3): average or above average difficulties and
  • Symptom Checklist 90-R (SCL-90-R): mild through severe difficulties
  • “I assign less weight to the report of Dr. Rubenstein. In that assessment, the applicant completed a Pain Patient Profile (P-3) test whose results were consistent with the test administered by Ms. Aghamohseni. Dr. Rubenstein noted that the results “might suggest clinically significant levels of affective and somatic distress”. In the face of that conclusion, Dr. Rubenstein then relies on a Structured Inventory of Malingered Symptomatology (SIMS) test which he says makes it “difficult if not impossible to lend validity to other test scores”. Rather than administer any of the other standard psychological tests, Dr. Rubenstein jumped right to a test designed to show an applicant is feigning or exaggerating symptoms, which in my view makes his report less compelling.”
  • ”In an addendum report dated March 30, 2020 Dr. Rubenstein stated that the diagnosis of Ms. Aghamohseni was not adequately supported as it relied “almost exclusively on the subjective reporting of the claimant”. I disagree with that conclusion as the diagnosis was based on five psychological tests which are designed to measure psychological symptoms. By their very design, a psychological test requires input from the individual being tested.”

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