Posted On: February 26, 2009

Brain Injury Claims: New Guidelines to Diagnose Mild Traumatic Brain Injury

New Guidelines to Diagnose Mild Brain Injury

The American College of Emergency Physicians has established new guidelines to be used in diagnosing mild traumatic brain injury.

Serious but Undiagnosed Injury

Mild traumatic brain injury has to be one of the most serious, yet undiagnosed health problems in Canada. Unfortunately, the general public has little understanding of what mild traumatic brain injury is and the problem is compounded by a poor understanding by some health professional about the criteria for what constitutes a brain injury.

Each year approximately 700 Nova Scotians suffer a traumatic brain injury. There are up to 5,000 - 6,000 serious car accidents in Nova Scotia and P.E.I. each year. Given the violent nature of car crashes, many of these people will suffer a mild traumatic brain injury, although they may never be diagnosed by a health professional.

No One Knows the Real Numbers!

In their release announcing the new guidelines, the College of Emergency Physicians states:

“The real incidents of traumatic brain injury are unknown since many patients who sustain an injury never seek medical care.”

I fully support any initiative that makes it easier for health professionals to determine when a patient has suffered a brain injury. But more effort needs to be placed on educating the public about the causes, and symptoms, of mild traumatic brain injury.

Thanks to Bruce Stern at the Traumatic Brain Injury Law Blog for bringing the guidelines to my attention.

Related Posts:

Ban Fighting in Hockey to Prevent Brain Injuries – Deaths: Expert Panel

NHL Hockey Stars - Doctors team up to study concussion/brain injuries

Traumatic Brain Injury: Myth # 1 - You have to be knocked out to suffer a brain injury

Traumatic Brain Injury Claims: Myth #2 You Have to Hit Your head to Suffer a Brain Injury

What is a Mild Traumatic Brain Injury?

Continue reading " Brain Injury Claims: New Guidelines to Diagnose Mild Traumatic Brain Injury " »

Posted On: February 25, 2009

Benefits of “Minor Injury” Cap Legislation does not Justify Discrimination

Justice Walter Goodfellow has released the second part of his decision in Hartling v. Nova Scotia (Attorney General).

"Minor Injury" Cap Isn't Unconstitutional

As I explained in a previous post last month: “Minor Injury” Compensation Cap Constitutional, Justice Goodfellow determined that Nova Scotia’s legislation that places a cap of $2,500.00 on the compensation that innocent accident victims can receive for their pain and suffering does not violate the Canadian Charter of Rights and Freedoms.

Accident Victims Not Sterotyped or Discriminated Against

In his decision of January 12, 2009, Justice Goodfellow ruled that victims of minor physical injuries were not subject to stereotyping or discrimination. Therefore, the legislation did not violate Section 15 of the Charter, which prohibits discrimination on the basis of a physical characteristic.

Similarly, Justice Goodfellow found that the legislation did not discriminate on the basis of gender or mental disability.

Accident Victims Disappointed - Insurance Companies Happy

Justice Goodfellow’s decision disappointed advocates for accident victims who felt that the legislation was simply a transparent attempt to increase insurance company profits at the expense of innocent accident victims.

The Insurance Bureau of Canada was no doubt very happy about the decision.

However, Justice Goodfellow’s decision of February 9, 2009, is guaranteed to create some consternation amongst the insurance industry.

Is Discrimination Justified?

In his latest decision, Justice Goodfellow provided his views on whether the legislation would survive a Section 1 analysis under the Charter. If the Minor Injury legislation is discriminatory, Section 1 of the Charter can still save the legislation if the discriminatory limits are “justified in a free and democratic society”.

Justice Goodfellow began the second part of his decision by stating that he is certain that he is correct when he ruled that the Minor Injury legislation is not discriminatory. However, given the effort that was put into the hearing by all of the parties involved Goodfellow J. felt that it was appropriate to conduct the Section 1 analysis in case the Court of Appeal differs with his views as to whether the legislation is discriminatory.

Justice Goodfellow conducted an exhaustive review of the evidence submitted during the hearing with respect to the reasons why the legislation was created.

Insurance Industry Pleads Poverty While Profits Increase

Goodfellow J. paid considerable attention to the financial evidence that was presented at the hearing. At the time the Minor Injury cap was introduced, the insurance industry claimed that it was losing money on auto insurance, and needed the cap on personal injury claims to protect insurance profits (and to supposedly lower auto insurance premiums).

Justice Goodfellow determined that the evidence actually showed insurance industry claims costs were decreasing, and company profits were increasing, when the Minor Injury legislation was introduced. Goodfellow indicated that the insurance industry had not provided this financial information to the government when the $2,500 cap was put in place.

His Lordship did not go so far as to say that the insurance industry had mislead the government. (Perhaps the Tory government was just too trusting?)

Goodfellow J. considered the negative effects of the legislation on accident victims who’s claims have been capped.

Minor Injury Cap has Provided Considerable Benefits?

Finally, His Lordship reviewed the evidence with respect to the benefits of the legislation.

He concludes by saying:

“There is no doubt that there has been considerable benefit to the citizens of Nova Scotia in the passing of this legislation.”

Benefits Don't Justify Discrimination!

Justice Goodfellow concludes, at paragraph 108 of his decision:

“Clearly there was no intent in the legislation to cause stereotyping or marginalization. Stereotyping almost always carries a negative, demeaning message that those who are stereotyped are less worthy and possess traits that are not held by decent, law abiding citizens. If, however, it had been established such was a consequence of the legislation, then I conclude the benefits of the legislation fall short of justifying such stereotyping. Given the view I express about stereotyping I am unable to suggest what the Attorney General of Nova Scotia might otherwise have done to overcome the consequences of stereotyping.”

In other words, Justice Goodfellow is of the opinion that the legislation does not discriminate against accident victims. But if it does, the object of the legislation is not one that can be justified in a free and democratic society. Goodfellow’s comments appear to imply that, if the legislation is discriminatory, then there is nothing that can be done to justify the discrimination!

So there you have it, win one lose one. The province and the insurance industry come out ahead on the issue of whether the Minor Injury legislation is unconstitutional.

But Justice Goodfellow sides with injured accident victims on the issue of whether the benefits justify discriminating against accident victims.

No doubt the Court of Appeal will not just be hearing an appeal from the Plaintiffs. I am sure lawyers for the Insurance Bureau of Canada are already drafting their appeal factums.

Continue reading " Benefits of “Minor Injury” Cap Legislation does not Justify Discrimination " »

Posted On: February 10, 2009

Ban Fighting in Hockey to Prevent Brain Injuries – Deaths: Expert Panel

Concussion a Major Cause of Injury in Sport

Traumatic brain injury due to concussion is a leading cause of injury in hockey. An expert panel at the London Hockey Concussion Summit has called for the elimination of high hits and head hits and a total ban on fighting in hockey.

Fighting can Cause Long Term Injury or Death

The panel’s conclusions state:

“Fighting is one of the known causes of concussion, and may result in the related long term complications. Fighting can cause needless death”.

The summit’s chair, Dr. Paul Echlin, stressed that the various recommendations were designed to “serve as a framework for future discussion” and to promote awareness, prevention, recognition and management of concussion in hockey.

Danger Not Limited to Hockey

The danger of concussion is not limited to hockey alone. Football, soccer, basketball, almost any amateur or professional sport can subject a player to forces necessary to cause a concussion. Players, coaches and family members need to be educated about the signs and symptoms of concussion.

However, hockey appears to be the only sport where fighting is tolerated, even encouraged. Until this attitude changes hockey players are going to be needlessly and seriously injured for the edification of the sports "fans”.

Fans Oppose Eliminating Fighting

You can get an idea of the vigorous opposition to eliminating fighting in hockey by taking a look at the comments posted on the CTV News story that reported on the recommendations. More than half of the comments oppose eliminating fighting in hockey.

No doubt the fans who support fighting in hockey will continue to hold that opinion until they, or one of their loved ones, suffers a serious brain injury from being punched out during a hockey game.

What do you think? Should fighting in hockey be banned or is it a necessary part of the game?

Related posts:

NHL Hockey Stars - Doctors team up to study concussion/brain injuries

NHL, Parents Need to be Aware of Brain Injury from Concussion

Traumatic Brain Injury: Myth # 1 - You have to be knocked out to suffer a brain injury

Traumatic Brain Injury Claims: Myth #2 You Have to Hit Your head to Suffer a Brain Injury

What is a Mild Traumatic Brain Injury?


Continue reading " Ban Fighting in Hockey to Prevent Brain Injuries – Deaths: Expert Panel " »