MIG Update – August 26, 2024
What Exactly Constitutes “Compelling” Evidence?
This week, a MIG hold where the Tribunal considered the Applicant’s medical records detailing the pre-existing conditions and diagnostics, in determining that the records in of themselves were not ‘compelling’. This term, has been referred to as a ‘subjective measure’ by the Tribunal and continues to be elusive as may well be the case in this week’s featured decision.
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Factor: Medical Records
In Misiti v. Aviva (22-006530), Felicia Misiti was involved in a motor vehicle accident on September 23, 2020 and sought entitlement to a Treatment Plan for chiropractic services outside of the MIG.
Misiti submitted that she should be removed from the MIG due to exacerbated pre-existing headaches, and neck and back pain, as evidenced by the CNRs of her family doctor Dr. Campos-Bustamante, physiatrist Dr. Chmiel rheumatologist Dr. Legault, and neurologist Dr. Farhani. dated June 2022, which indicated that she had headaches since she was 17, and it was aggravated by the accident.
Aviva disagreed, and relied on the GP IE report of Dr. Kopyto dated January 2022 which opined that Misiti suffered a minor injury from the accident, and that her pre-existing injury would not preclude her recovery in MIG.
The Tribunal found:
- Although family doctor Dr. Campos-Bustamante noted Misiti’s pre-existing conditions and physiatrist Dr. Chmiel documented her treatment, but neither of them provided a diagnosis or compelling medical evidence that suggested her pre-existing conditions would preclude her recovery from an accident-related injury.
- The diagnostic imaging results found in the CNRs of rheumatologist Dr. Legault revealed that Misiti’s pain was mechanical in nature, and there was minimal damage found….“January 12, 2021, the doctor noted myofascial neck pain. In review of the CNRs, I am not directed to compelling medical evidence to prove that the applicant would be precluded from recovery from any accident-related minor injury if she were kept in MIG.”
- The IE report of GP Dr. Kopyto dated January 2022, opined that Misiti’s neck and back pain had not changed following the accident. This opinion was given weight as it aligned with Misiti’s medical records.
- “The neurology report of Dr. Farhani completed on June 6, 2022, was the result of a telephone interview with the applicant. The report notes that the applicant has had headaches since she was 17, and the doctor posits that the headaches have been aggravated by the motor vehicle accident. An interesting note in this report is where the doctor also mentions that neck pain can be a prodromal symptom of migraine, which the applicant reports suffering from since she was 17.”
- Overridingly, they were not directed to ‘compelling medical evidence’ and the records lacked detail that stated the pre-existing injuries referenced in the records would prevent recovery if Misiti was kept to the MIG limits.
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?