Hello to all our reader,
In this Newsletter, we are presenting a recent case about attendant care benefit following a Brain Injury.
In J.W. Vs SNIC, (J.W. vs. Security National Insurance Company 2020 ONLAT 18-008988/AABS), an applicant was seeking resolution for attendant care benefits (ACBs), dating back to October 14th, 2016 to the present-date and ongoing, with interest on any overdue payments.
The accident occurred on October 20, 2014. The client sustained a brain injury and fractures to the skull, spine, ribs, leg, and wrist. The applicant’s impairments were determined to be catastrophic by the respondent.
Initially, benefits were paid out for Attendant Care Benefits until May 2016, when the insurer requested a new Assessment of Attendant Care Need (Form-1.
The applicant has experienced catastrophic cognitive injuries. He was able to return to an intellectually intensive profession, as a litigation lawyer. As a result of his injuries, he suffers from fatigue, which was more severe at the end of the working day. When he came home he required emotional support, and cues and reminders due to forgetfulness and irritability after work. This support was provided by his wife.
The arbitrator agreed with the OT opinion that the applicant’s work pace had to be considered as its effects on his cognitive behaviour after work
The arbitrator agreed that the analysis of the client’s function and need for attendant care should include his physical independence and his residual cognitive impairment due to his traumatic brain injury.
At GLA Rehab, our OT assessments include the screening of physical, psychosocial, behavioural, cognitive or perceptual functions. This lends a comprehensive insight into the client’s ability to manage his/her self-care tasks.
It is our OT practice to refer to the OSOT publication 2009 and 2011 “Assessment of Attendant Care Needs, Form 1: A Resource for Reflective Practice.” (Click here)
This publication clearly states consideration must be given to the impact of all injuries and sequela arising from the automobile accident which impact function, whether that is from a physical, psychosocial, behavioural and/or cognitive perspective.
This publication states that when assessing attendant care needs, one must consider the predictability and consistency of a client’s performance (physical, cognitive, behavioural).
Following a brain injury, clients experience fatigue, especially at the end of the working day. The fatigue is affecting the ability to complete cognitive tasks at home, which can result in irritability.
They require cues and reminders and at times, they require emotional support. This falls under the “Basic Supervisory Care” of Form #1.
Components of a comprehensive assessment include both subjective and objective information gathered from the client and other relevant or collateral sources.
According to the OSOT publication, when assessing a client for attendant care needs, it is important to consider the following:
• Review Medical records and information provided by the treatment team.
• Interview the client and identified Subjective barriers to function.
• Collect collateral information (e.g. from healthcare providers, family, friends, and relevant sources).
• Collect objective information, which includes using objective measurements and direct observation and demonstration of activity as appropriate (motor and cognitive-behavioural processes).
• Completed relevant cognitive screening and/or assessment, perceptual screening and/or assessment.
By considering this publication, our OT reports are providing sufficient information to all readers (clients, insurers, lawyers and arbitrators) to justify our recommendations and to be convincing when it comes to attendant care needs.
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