My answer to these submissions is that a positive medical opinion as to causation is not essential to a finding on this issue. Considering the cumulative effect of all of the circumstances, including the medical evidence, a trial judge is entitled to draw a common sense inference: Snell v. Farrell, 1990 CanLII 70 (SCC), [1990] 2 S.C.R. 311 at para. 44. That is what the trial judge did here and his conclusion is entitled to deference.
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