Concussion and Long-Term Disability Claims – What You Need to Know

Posted by Rupa Karyampudi , Partner, MK Disability Lawyers

There has recently been a lot of discussion surrounding concussions, particularly in sports. Yet, a concussion can happen to anyone who has sustained a blow to the head, face, neck, or upper body. While most people recover from a concussion within a month, there are some people who have long-lasting symptoms that prevent them from returning to work.

In this article, we will discuss what a concussion is, how it is diagnosed, the symptoms associated with a concussion, treatment, prolonged symptoms, and how long-term disability insurers treat concussion claims.

What is a concussion

A concussion or a mild Traumatic Brain Injury (mTBI) is an injury that affects how your brain functions. It is usually caused by a blow to the head, face, neck, or upper body.

Your brain has the consistency of gelatin. It is cushioned and protected by cerebrospinal fluid inside your skull. A strong blow to the head, neck, or upper body can cause the brain to slide back and forth against the inner walls of your skull. Sudden acceleration or deceleration of your head can also cause your brain to hit the walls of your skull, causing injury. These injuries affect brain functions.

Falls, workplace injuries, falling objects, contact sports, motor vehicle collisions, pedestrian or bicycle accidents, or being a victim of physical abuse are examples of actions that can cause a concussion.

Diagnosis

If you think that you may have a concussion, it is important to get assessed by a healthcare professional immediately. Your doctor will evaluate your symptoms, review your medical history, and conduct a neurological examination. Your doctor will diagnose you with a concussion by ruling out more severe types of injury to the brain or spine. They will assess your ability to see, walk, think, and remember. They will also assess your balance, reflexes, muscle strength, sleep patterns, and mood. If necessary, your doctor may send you for diagnostic scans of your head and neck.

Symptoms of concussion

The signs and symptoms of a concussion can be subtle and may not be apparent immediately. Some symptoms may appear right away. Other symptoms may appear after several hours or several days. The symptoms of a concussion can range from mild to severe and can last hours, days, weeks, or even months.

According to the Ontario Neurotrauma Foundation’s Guideline for Concussion/Mild Traumatic Brain Injury & Persistent Symptoms, common symptoms of concussion include:

Cognitive

• Feeling foggy

• Hard time remembering and focusing

• Speed of information processing

• Trouble thinking clearly

• Trouble finding words

• Judgement

• Executive functioning, such as decision making, planning, and motivation

Physical

• Headache/migraine

• Dizziness and balance problems

• Nausea

• Fatigue

• Sleep disturbance

• Blurred vision

• Sensitivity to light or noise

• Hearing problems

Behavioural

• Depression

• Nervous or anxious

• Agitation

• Irritability

• Impulsivity

• Aggression

• Angry

• Sad

• Sleep more or less than you normally would

• Hard time falling asleep or staying asleep

• Ringing in the ears

• Seizure

• Temporary problems with smell and/or taste

• Numbness and tingling

• Neck pain

Treatment

Rest is the most effective way of allowing your brain to recover from a concussion. You need to physically and mentally rest to recover from a concussion.

Your brain is more susceptible to further damage after you have suffered a concussion. Therefore, while you are recovering, it is important to avoid activities that may cause another head injury. It is important to allow yourself time to recover and to gradually return to your regular activities.

If you are diagnosed with a concussion, your doctor should give you a management plan to help you recover. This management plan should be personalized and based on your symptoms and assessment results and to best fit your lifestyle. Some examples of treatment that may be recommended are vision therapy, specialized glasses, vestibular therapy, pain medication for headaches, physiotherapy for headaches, etc.

Many factors can influence how a person will recover from a concussion. Each concussion is unique and should be treated on a case-by-case basis. It is important to tell your doctor if you have a history of mental health issues as this may affect your symptoms and your recovery.

Prolonged Symptoms

The length of time for recovery varies from person to person. Most people recover from a concussion within a month. Some people will have symptoms from 1 – 3 months. In about 15% of cases, symptoms can last longer than 3 months. Symptoms lasting longer than 3 months are called “prolonged symptoms”. If your symptoms are prolonged, you may be diagnosed with “post-concussion syndrome”.

According to the Ontario Neurotrauma Foundation, it may take you longer to recover from a concussion if you:

Are a teenager or an older adult;
Are female;
Go back to school, work, or exercise too soon;
Have had a concussion before;
Have a history of migraine headaches;
Have mental health issues such as depression or anxiety;
Have trouble sleeping; or
Are showing signs of vestibular or visual abnormalities (e.g. blurred vision, dizziness, difficulty focusing, motor sensitivity)

Post-concussion syndrome can significantly affect a person’s daily functioning, including returning to work. Because of this, prolonged symptoms need to be closely monitored by your doctor. Your family doctor may refer you to other healthcare providers to treat your specific symptoms including mental health specialists, rehabilitation providers, and/or a specialized concussion clinic.

Long-term disability and concussions

When you are planning your return to regular activities, including work, you need to consider both cognitive and physical activities which may make your concussion worse. It is important that you not return to work before you are cleared by your doctor. If your doctor feels that you are ready to return to work, it is important that your employer accommodates your physical and cognitive limitations and restrictions. Your doctor will help you identify any limitations and restrictions that will require accommodations at work.

If your symptoms persist and you are unable to return to work, you should apply for short-term disability benefits. If you have not recovered after the short-term disability period ends, you need to apply for long-term disability benefits. Returning to work before you are recovered can aggravate your concussion symptoms and make your condition worse, prolonging or even limiting your full recovery.

Since concussions are “invisible injuries”, disability claims are often denied by insurance companies. The insurance company may take the position that there is no “objective medical evidence” such as a CT scan, MRI or blood test to prove that you are suffering from post-concussion syndrome. Insurance companies often expect that you will recover from your concussion within medically prescribed timelines and should you not, they may question your credibility, your treatment and your ability to work and deny your claim. At MK Disability Lawyers we have represented many clients with concussions. We know the type of medical evidence that is needed to persuade the insurance company that you are unable to work.

We also understand that clients with concussion symptoms will require very specific accommodations throughout the litigation process. At MK Disability Lawyers, we strive to make those accommodations readily available to our clients; whether it be by communicating in a way that does not aggravate concussion symptoms (in-person or by telephone, avoiding electronic communications), darkening our meeting room, following up our meetings in writing detailing our discussion, not setting a time limit on our discussions or meetings, among other accommodations, and by generally exercising extra patience and compassion with the understanding that concussion symptoms can be frustrating and limiting to our clients.

If you have suffered a concussion and if your claim for short-term or long-term disability has been denied or terminated, contact us for a complimentary consultation.

MK Disability Lawyers has over 20 years of experience between its two partners in disability law. We provide personalized legal representation to disabled clients whose disability claims were denied. If you need legal advice on your disability claim, if you have questions about your rights, or if you would like a free consultation, please contact us at info@MKDisabilityLaweyers.com.

The preceding is not intended to be legal advice. This blog is available for educational purposes only as well as to give you general information and a general understanding of the law, not to provide specific legal advice. By using this blog, you understand that there is no solicitor-client relationship between you and the blog publisher. The blog should not be used as a substitute for competent legal advice from a licensed lawyer in your jurisdiction. If your employment has been terminated because of your disability and you need legal advice, contact a lawyer specializing in disability law.

Sources:

https://www.mayoclinic.org/diseases-conditions/concussion/symptoms-causes/syc-20355594

https://www.healthlinkbc.ca/health-topics/tp23364spec