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GLA Newsletter  |  Issue 21  |  January 2017
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The Risk of Developing Dementia Following a Traumatic Brain Injury
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Hello to all of our Readers,

Happy New Year!

A recent FSCO decision, Veeran vs. State Farm, explored the perception and characteristics of Chronic Pain Syndrome.

In this case the client was 35-years-old at the time of the MVA, and 5 months pregnant. She was working in a factory full-time and was also working overtime. At the factory she was required to stand, manipulate objects with her hands and work quickly.
 
Post-accident the client’s insurer placed her in the Minor Injury Guideline (MIG).
 
Her treating chiropractor noted her diagnosis as: sprain and strain injuries to her spine, whiplash associated disorder, headaches, sleep problems and anxiety. Her progress in therapy was affected by her pregnancy, which caused difficulty completing the rehab program.
 
Her family physician records showed a post-accident history of neck pain, which was deemed chronic, starting in June 2013.
 
Chronic pain was diagnosed in August 2014.
 
Following the MVA Ms. Veeran was unable to return to work due to her injuries. She had limited tolerances for standing and sitting. Accommodations in her workplace were not available, and she was not trained beyond factory work.
 
In 2016 Ms. Veeran tried to work at Tim Horton’s, making coffee and drinks. Her work performance was too slow, and she mixed up orders. She was not hired for the job.
 
During the arbitration State Farm was of the position that Ms. Veeran had experienced minor injuries as a result of the accident, and did not return to work because she had three children under the age of 8 to care for at home.
 
A psychiatric IE assessment completed in 2013 diagnosed a Somatoform Pain Disorder, and a chronic pain assessment was recommended.
 
State Farm did not carry out the assessment, despite the advice of the assessor.
 
In November 2015 Dr. Boucher, physician, completed a chronic pain assessment and diagnosed the client with Chronic Pain Syndrome (CPS) and Somatoform Pain Disorder.

Dr. Boucher pointed out that:

“Inconsistency in pain symptoms does not delegitimize the diagnosis of CPS; rather it is an inherent part of the condition”.
 
The arbitrator agreed with Dr. Boucher’s diagnosis and expert report, and granted IRB benefits to the client from the date of the accident to present.
 
This is a very important decision for our practice.
 
GLA is a treating rehabilitation company, and our therapists including: OTs, SWs, RSWs and PTs often observe inconsistencies with pain symptoms. In our reports we aim to describe a good day and a bad day, with regards to the client’s pain, which Dr. Boucher stated “is an inherent part of the condition”.
 
As rehabilitation personnel, we increase our client's awareness of their fluctuations in pain symptoms. We encourage our clients to be productive on days they are able to do more, while providing pain management strategies on days when symptoms flare.   
 

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

The Risk of Developing Dementia following a Traumatic Brain Injury

This article proposes that, although much of the discussion of the link between traumatic brain injury (TBI) and an increase risk in dementia remains confidential, research points to some very compelling evidence that this population is at a higher risk indeed. 
Read more...
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