What is PTSD?

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Post-Traumatic Stress Disorder (PTSD) occurs when a person has been exposed to trauma. This includes accidents, serious injury or even witnessing a fatality. Nightmares, accident flashbacks, and heightened anxiety for a prolonged period may be signs of PTSD. Unfortunately, many insurance companies want to insist that this condition simply ‘passes after a few weeks’ and is not serious.

We have had many clients who had PTSD as a result of their serious injuries, or seeing loved ones injured or even killed in an accident. Many have developed depression, severe anxiety, and avoidant behaviours. Without proper treatment, PTSD may become unbearable and cause a person to spiral psychologically, ruining careers, relationships, and future plans.

The primary treatment for PTSD is psychotherapy, but can also include medication. Combining these treatments can help to improve symptoms by teaching skills to cope and reframe trauma, treating co-morbid depression, anxiety, or addiction, and relaxation techniques. The types of psychotherapy usually employed include:

Cognitive Behavioural Therapy (CBT) This type of talk therapy helps you recognize the ways of thinking (cognitive patterns) that are keeping you stuck. This could be negative beliefs about yourself and the risk of traumatic things happening again. For PTSD, cognitive behavioural therapy is often combined with exposure therapy.

Exposure Therapy

This behavioral therapy helps you safely face situations and memories that you find frightening to learn to cope with them effectively. Exposure therapy can be particularly helpful for flashbacks and nightmares. Guided sessions with virtual reality programs allow you to re-enter the setting in which you experienced trauma and reframe them.

Eye Movement Desensitization and Reprocessing (EMDR)

EMDR combines exposure therapy with a series of guided eye movements that help you process traumatic memories differently so that they are no longer physically and emotionally draining. EMDR aims to reduce symptoms of trauma by changing how your memories are stored in your brain by leading you through a series of bilateral (side-to-side) eye movements as you recall traumatic or triggering experiences in small segments. EMDR may also help relieve symptoms of other mental health concerns, especially those intertwined with past trauma.

Insurance companies may deny you benefits to access these types of therapy because of treatment costs compared with usual physical rehabilitation. We understand how difficult it is to experience an invisible illness and have assisted many clients with denied claims for PTSD. We are available to speak with you and answer your questions.

Acquired Brain Injury

A traumatic brain injury (TBI) is defined as an alteration in brain function or other evidence of brain pathology caused by an external force. An acquired brain injury (ABI) is an injury to the brain which is not hereditary, congenital, degenerative or induced by birth trauma.

An acquired brain injury alters how the brain performs tasks and can be described as mild, moderate or severe. The primary causes of acquired brain injury are trauma (accidents that cause closed or open injuries), stroke (blocked artery, aneurysm), anoxia (lack of oxygen to the brain), infection (encephalitis, meningitis), tumor, and surgical procedures.

Many of our clients who have sustained severe whiplash in a car accident also sustain a concussion due to the rapid acceleration / deceleration forces. As a result, the blood vessels in their brains stretch and cranial nerves are damaged. A person may or may not experience a brief loss of consciousness due to concussion. The injured may remain conscious, but act or state that they feel “dazed” and unable to remember what happened. Most concussions happens at a microscopic scale, and may or may not show up on a diagnostic imaging tests such as CAT scans. As a result, a concussion causing ABI is sometimes defined by exclusion, and is considered a complex neuro-behavioral syndrome with many signs and symptoms including mood changes and cognitive impairment.

Our team at SLSPC has over 20 years experience managing claims for acquired brain injury due to accident or medical malpractice. Call 416-644-3999 or sspadafora@slspc.ca for a free and confidential consultation.

What is a Threshold Denial?

In August, 2015 the Government of Ontario implemented changes to the Ontario Insurance Act, R.S.O 1990, C.I.8 in order to lower costs for insurance companies. One of the key changes made was to increase the amount of deductible for accident claims. The "deductible" is the amount of an injured person's pain and suffering award that is stripped away by the Ontario government insurance laws. Accident victims do not receive the full value of their claims for pain and suffering or loss of enjoyment of life ("non-pecuniary damages") unless the claim exceeds $138,343.86. Below this amount, called "the threshold", if a claimant is awarded damages for pain and suffering / loss of enjoyment, there is a deductible applied by the insurance company.

The amount of this deductible increases every year as it is indexed to inflation set at 1.6%. Prior to the 2015 change in insurance legislation, the deductible amount was $30,000. Effective on January 1, 2022 and until the end of this year, $41,503.50 will be deducted from awarded non-pecuniary damages. However, if the victim’s pain and suffering is assessed as more than $138,343.86 then the deductible does not apply. This means that if an accident victim was awarded $50,000 for pain and suffering, they will actually receive only $8,496.50 ($50,000 - $41,503.50). You need a lawyer to ensure you are not subjected to a threshold denial. Call 416-644-3999 or sspadafora@slspc.ca for a free and confidential consultation.