GLA Newsletter  |  Issue 18 |  May  2015
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Hello to all our readers!

In this edition of the newsletter, we have chosen to highlight a recent motion, Georgios Apostolidis and Wawanesa Mutual Insurance Company (FSCO A12-0040701), which discusses how Pain Disorder can meet the catastrophic threshold on the Mental and Behavioural criterion in the OCF-19.

This case is important, as there was an argument on how data on the client’s ability to function was collected.

Although the arbitrator designated the client Catastrophic, it may be more convincing and less argued in future cases if more data would be collected by the OT to support behavioural problems affecting independence with ADLs, which is the OT’s domain after all.
On October 30, 2009, Mr. Apostolidis was injured in a motor vehicle accident. He sustained 3 fractures in his left leg and ankle requiring multiple surgeries and a laceration to his nose requiring several stitches.

He began to experience headaches, pain in his right shoulder, neck and lower back. He was participating in physiotherapy and taking pain medication in order to help alleviate his pain. He also began to develop pain in his right leg as he was carrying most of his weight on this leg to eliminate weight on the left injured leg.

Prior to the accident, the Applicant worked up to 60 hours per week as a cook and lived a busy social lifestyle with his wife. They enjoyed going out with friends and travelled on an annual basis. Following the accident, according to Mr. Apostolidis, his life had been turned upside down. He was not able to return to work, lost contact with his friends and had to move to a smaller apartment due to financial reasons and the upkeep required with a house. As well, he had lost his intimacy with his wife and they began sleeping in separate bedrooms.

Mr. Apostolidis applied for catastrophic determination based on both 55% Whole Person Impairment and the Mental and Behavioural criterion. The insurer assessors determined that the claimant did not meet the definition of catastrophic impairment under either Whole Person Impairment or Mental and Behavioural Disorders.

Dr. Hines, the insurer Psychiatrist, felt that the Applicant appeared fully oriented and focused with no evidence of any disorder, no evidence of anger, irritability, impatience or difficulty with concentration and concluded that he did not have any mental and behavioural impairments.

Dr. Gerber, the Applicant’s Psychiatrist, concluded that Mr. Apostolidis did suffer a Class 4 Marked Impairment in the category of Activities of Daily Living. Dr. Gerber reported,

“Psychological factors, including depression, how bothered he is at his inability to function and how helpless he feels at ever getting better, play an important role in the severity and maintenance of his pain. Mr. Apostolidis meets criteria for the diagnosis of pain disorder associated with both psychological factors and a general medical condition,,. Pastore v. Aviva Canada Inc. stated that ‘a cumulative approach must be used to consider pain in the realm of physical and mental disorder’”.

There was an argument that Dr. Gerber relied too much on the Applicant’s self-report rather than using objective standards but the Arbitrator rejected the argument and found that Mr. Apostolidis was catastrophically impaired because he had a Marked Impairment due to a mental or behavioural disorder and agreed with Class 4 Impairment (Marked) in the areas of activity of daily living.  

At GLA we conduct a situational assessment to collect objective data on the client’s ability to function and include all the 4 spheres on the Mental and Behaviour chapter #14 in the AMA guides. Our therapists have received certification through the American Board of Forensic Professionals in the 4th Edition of the AMA guides to the Evaluation of Permanent Impairment.
This assessment report will assist CAT assessors and arbitrators with their decision on CAT designation, as it shows how much and at what efficiency (pace, mistakes, duration) the client can do in a day, considering pain, depression, fatigue, anxiety and other mental symptoms.  
To learn more about our situational assessments, please contact us.
With the approach of the summer months, we have chosen to highlight the importance of bike and helmet safety on our blog. To read more about helmets, bikes, and road safety, visit our blog.
Our second blog post this month covers career development theories and vocational choices. It was written by one of our social workers and vocational specialists, Iva Keighley. To learn more about this important topic, click here.  

We are excited to be a Silver Sponsor at the Brain Injury Diagnostics: What’s New and What You Need to Know Conference hosted by MRI Appointments, OBIA & BIAD on June 2, 2015 in Oshawa. 

We will also be a Silver Sponsor at the June 10th, 2015 BIST/OBIA Mix and Mingle event, an event that raises awareness of brain injury, as well as funds to support ongoing programs and services.

We hope to see you all there!

Best Regards,
Galit Liffshiz, MA OT Reg. (Ont.)
President of GLA
Expertise and Experience in Life Care Planning
Designated Capacity Assessor

Helmet and Bike Safety

With the sun shining and the summer months approaching, it is time to pull out your bike from the garage and enjoy a bike ride. But before you do this, you need to learn about bike safety and how to prevent accidents from happening. Read more...

Career Development and Employability Dimensions

Career development can be defined as the total constellation of economic, sociological, psychological, educational, physical and chance factors that combine to shape one’s career. Read more...

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