Medical Witnesses at AIAC Appeals: Why Your Voice Matters

If you are a practitioner involved in the care of someone who is appealing an SGI decision to the Auto Injury Appeal Commission, you may be asked if you would be willing to appear as a witness at a hearing. This may seem like a daunting or even unappealing prospect. Many people who are in healing professions are not interested in engaging in legal conflicts, especially when they are unsure what their participation would entail.

Disputes about the cause of injuries can be particularly tricky. There is often no test that can identify the cause of ongoing symptoms, especially when it comes to injuries like whiplash, traumatic brain injury, or chronic pain when injuries would have been expected to resolve. Specialists providing opinions on causation may not feel it’s worth risking their professional reputation—or their time—by attending a hearing to state that symptoms are most likely caused by an MVA.

Unfortunately, these concerns are not unfounded. In my experience, the opinions of well-meaning care providers in Saskatchewan can be called into question or even disparaged by SGI consultants. SGI’s lawyer attending the hearing may allege that their presence is driven by personal loyalty to the patient rather than their professional opinion.

Many of SGI’s consultants, on the other hand, are paid well to attend hearings several times a year. They are trained in how to present evidence at a hearing and how to respond to cross-examination. The Commission has not recognized that these consultants may have a conflict of interest, even if their ongoing work depends on providing opinions aligned with SGI’s business interests.

All of this being said, here are five reasons why you should attend a hearing if you believe that symptoms are caused by an MVA:

1. Your expertise matters. Because of the nature of the appeal process, the Commission is Very Used to hearing from certain doctors – with certain medical ideologies – and not others. Do you agree with the SGI consultants who have provided opinions on a file? Do you not? That is very useful information to have, even if your opinion doesn’t end up being preferred by the Commission. A rising tide lifts all boats.

2. This gratitude will (mostly) be evident to you. In my experience, Commission panel members are appreciative to medical witnesses who take the time to explain their opinions and provide context to a hearing. The written decisions will almost certainly be respectful towards you and your efforts, and SGI consultants usually respond professionally as well.

3. It aligns with your professional role. Helping patients access benefits they’re entitled to is consistent with professional responsibilities. For example, the Saskatchewan Medical Association fee guide notes that physicians have a duty to “expeditiously assist patients in obtaining those benefits to which they are legitimately entitled.” Being accused of bias by SGI does not negate the value of your professional opinion. You can consult your governing body or insurance provider for guidance if needed.

4. Not appearing can hurt the case. In my experience, the Commission panel seems to read into a lack of witnesses on behalf of the plaintiff. Even if the refusal from care providers to participate stems from a lack of time or compensation, a fear of reprisals from SGI, or stress or concern about the process, Commission members may believe that if a practitioner doesn’t attend the hearing to explain or support their report or records, it’s because they don’t stand by what they wrote.  

5. You don’t need a definitive answer to make an impact. Often, the key question is whether an individual would be experiencing these symptoms but for the accident. The Commission applies a balance of probabilities, meaning your opinion about the likelihood—along with your reasoning—can be influential, even if certainty isn’t possible.

 If you are a practitioner treating SGI clients and have questions about appearing as a witness at an AIAC hearing, I would love to hear from you!