MIG Update – August 16, 2021

Does Pre-Existing Psychiatric Condition Prevent Recovery Within MIG?

In this edition, we report on a MIG escape where it was undisputed that the Applicant had extensive pre-accident health conditions. The Tribunal’s analysis focuses on two IEs, which in fact, do support that the Applicant’s psychiatric history was exacerbated by the accident, preventing her from achieving maximal medical recovery under the MIG limits.

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Factor: Exacerbated Pre-Existing Psychiatric Condition

In Yadroozeh v Aviva (19-010010), it was undisputed that Yadroozeh had extensive pre-accident health conditions, including depression and chronic pain.

In a psychological IE dated February 2018, the psychologist could not make a formal diagnosis as a result of the subject 2017 accident but did opine that the accident did not “directly” relate to Yadroozeh’s significant psychiatric impairments. The assessor did not comment on whether or not Yadroozeh’s pre-existing psychiatric conditions were exacerbated by the accident, despite a detailed review of Yadroozeh’s long-standing psychiatric history.

In a subsequent psychiatry IE dated September 2019, the psychiatrist diagnosed Yadroozeh with Somatic Symptom Disorder and Major Depressive Disorder and opined that Yadroozeh did not sustain a new mental and behavioural disorder as a result of the accident but that her psychiatric symptoms appear to be an exacerbation of her pre-existing conditions. Therefore, it was opined that Yadroozeh “does not meet the criteria for [the] Minor Injury Guideline because of the severity of the pre-existing condition and the worsening of symptoms following this accident which only serve to reinforce her perception of being victimized and aggrieved.”

‘MIG escape’ – The Tribunal’s findings:

• Greater weight was placed on the psychiatry IE than the psychological IE done over a year prior
  
• The psychiatrist provided an opinion on whether or not the accident exacerbated Yadroozeh’s longstanding psychiatric impairments, rather than simply stating that the accident did not “directly” cause Yadroozeh’s psychiatric problems
  
• The psychologist’s comment that Yadroozeh’s pre-existing psychiatric problems “will likely prevent Ms. Yadroozeh from achieving maximum medical recovery from any true injuries within the Minor Injury Guideline” indicates that she is also of the opinion that the accident exacerbated the pre-existing psychiatric conditions
  
• The case law is clear that the accident need not be the sole cause of an impairment as it can also be a necessary cause, which is consistent with the psychiatrist’s opinion
  
• The findings of both assessors support the Tribunal’s conclusion that Yadroozeh’s well-documented psychiatric history that was exacerbated by the accident prevents her from achieving maximal medical recovery under the MIG limits

Related MIG Monday Issue:

“Compelling” Evidence That Prevents Achieving Maximal Recovery

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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