What is a Soft Tissue Injury?
Soft tissue injuries are injuries that damage muscles, ligaments, tendons, cartilage (intervertebral discs, knee meniscus) and nerves. These injuries can be caused by a strain, sprain or contusion.
A strain occurs when a soft tissue is stretched. The damage to the soft tissue may be on a microscopic level or involve a partial or complete tear of the affected soft tissue. A strain injury is common when a vehicle is rear-ended.
A sprain occurs when soft tissue (usually a ligament) is twisted to the point of pain, swelling or even being torn. A ligament may be stretched, partially torn or completely torn. A sprain occurs when the joint goes beyond its functional range of motion. If a person has his head turned to the left or right to watch for oncoming traffic, a rear-end collision will often result in a combination strain-sprain injury.
A contusion injury occurs when the affected muscles or connective tissue are crushed. A T-bone collision often results in a contusion injury.
Diagnosis of Soft Tissue Injuries
Most strain and sprain soft tissue injuries affect soft tissues in a manner which cannot be detected or verified by imaging tests, such as x-rays, MRIs or CAT-scans. Imaging tests are frequently used in more severe soft tissue injuries for the purpose of ruling out bone injury. A negative imaging test is what one expects with a soft tissue injury. Insurers will often argue that a negative imaging test indicates that there is no objective proof of injury.
Soft tissue injuries are generally diagnosed according to:
- the mechanism of injury;
- absence of bony injury;
- subjective symptoms reported by patient; and/or
- findings on examination by doctor in the nature of spasm detected on palpation and reduction in range of motion.
The first level of intervention is usually medication. Therapeutic interventions include massage therapy, physiotherapy, chiropractic and osteopathic medicine. Once the patient has reached a sufficient level of recovery to be phased back to a pre-injury functional level, the patient will often undergo occupational therapy or a supervised conditioning program in a gym. In certain instances where there has been a radical injury to soft tissue such as a tendon tear, surgical repair will be the first intervention.
Severity of Soft Tissue Injuries
The severity of a soft tissue injury depends upon several factors.
- The extent of the soft tissues that have been injured in an accident. Multiple soft tissue injuries are generally more disabling and more difficult to rehabilitate.
- The frequency, duration and amount of pain caused by the injury.
- The restrictions imposed by the soft tissue injury. A person's strength, postural and range of motion tolerances may be affected by the injury.
- The practical impact that the soft tissue injury has upon the injured person. For example, a mother of two young children who works in a fish plant will generally suffer more than a person whose position offers ergonomic adjustments, flexibility in the pace and type of work tasks, and the ability to take small breaks.
The effect if these variables is that an injury varies differently from one person to another. Medical opinions on the effect and degree of disability are generally expressed by family physicians, neurologists, orthopaedic surgeons and physiatrists. An occupational therapist and physiotherapist can provide a more precise opinion on the functional limitations experienced by the individual person. These tests are often done through functional capacity evaluations or (FCE). The FCE will evaluate the postural, strength and range of motion and other residual capabilities or tolerances. These tolerances are measured on a general scale as to whether the person can perform light, sedentary, medium or heavy work. If the evaluation is more precisely tailored to the person's occupation, the occupational therapist will compare a job site analysis (JSA), which sets out the physical requirements of a job and match those requirements against the physical tolerances of the injured individual.
Generic Rating of Soft Tissue Injury Severity
In 1995, the Quebec Task Force on Whiplash Associated Disorders (the Task Force) was established at the request of the insurance industry to set objective criteria for the diagnosis and prognosis of Whiplash-Associated Disorders. Despite the stated goal of establishing evidence-based objective criteria, the Task Force findings were not evidence-based. The literature relied upon by the Commission had a selection bias. It emphasized literature that supported the position that soft-tissue injuries were generally self-limiting, short-term discomfort and did not cause lasting disability. The guidelines established four general categories for neck complaints. This categorization system was most relevant and beneficial for treatment purposes. The categories were:
- WAD Grade I - Neck Complaint
- WAD Grade II - Neck Complaint and some musculoskeletal signs
- WAD Grade III - Neck Complaint and neurological signs
- WAD Grade IV - Neck Complaint and suspected fracture or dislocation.
This classification system is frequently used in medical-legal reports by physicians. The most common classification is WAD Grade II.
The difficulty with this categorization system is two-fold. First, the assessment of the WAD classification system between levels I and III is subjective. Second, it creates a standardized measure that does not indicate the particular individual's complaints, limitations and how those limitations affect the person's normal daily functioning. This approach can result in an underestimation of the real-life severity of the injury.
Acute and Chronic Injury and Fibromyalgia
An acute injury is the immediate aftermath of an accident. One of the first questions you will be asked is when did you first feel symptoms from the injury. In most instances, symptoms develop either immediately or within the first 48 hours of an accident.
Acuteness v. Severity of an Injury
The acuteness of an injury is not the same as the severity of the injury. It means the initial onset of the injury after the traumatic event and the initial immediate healing response by the body. Some literature defines the acute phase as the first 1 to 4 days after the injury.
Following the acute phase, the injury will go through a healing phase that ordinarily resolves within 6 months.
If pain and limitations continue beyond 3 months, the injury may be considered chronic. A chronic injury may be an injury that does not respond effectively to short-term treatment. Another characteristic of a chronic injury is that regular daily activities continue to provoke the injury.
In rare instances, a patient may develop fibromyalgia. A diagnosis of fibromyalgia is ordinarily highly contested. Some reputable physicians deny that fibromyalgia exists as a medical condition. The condition can be caused by a number of causes and will not develop immediately after an accident. It is characterized by widespread pain, stiffness and tenderness and fatigue. One of the diagnostic tests for fibromyalgia is a number of tender points on different parts of the body. Fibromyalgia is often a diagnosis of exclusion which applies where there is no other medical diagnosis which adequately explains the patient's symptoms. Although the diagnosis is controversial, the Newfoundland and Labrador Supreme Court has recognized fibromyalgia in a case where the condition substantially disabled the injured person.
If your soft tissue injury or chronic pain is the result of an accident caused by another party, then you may be eligible to file a claim for compensation. The problem with these types of injuries, however, is the extent of provable pain and the proof of the cause of pain, particularly with respect to chronic pain.
Compensation for Soft Tissue Claims
The most significant forms of compensation received by persons who suffer a soft tissue injury are:
- Pain and suffering. Courts typically apply a very broad spectrum of mild, moderate and severe to soft tissue claims to set general ranges for the compensation which will be awarded. Compensation for a mild very short-term soft tissue injury will be as low as $5,000 to $10,000. Compensation for a long-term severe soft tissue injury may be as high as $80,000 to $100,000. Pain and suffering include both physical harm and psychiatric injury which may result from an accident.
- Loss of past income.
- Loss of future earning capacity. This is the most controversial part of a severe soft tissue injury claim. The Plaintiff must prove or establish within a reasonable degree of likelihood the future compensation that the person would have earned but for the accident.
- Loss of ability to perform past and future household tasks. This category has the potential to be as controversial as loss of future earning capacity. It allows compensation for the value of services provided to an injured person on a voluntary basis by friends or relatives.
- Medical & Other Related Expenses. Expenses attributable to the accident, the largest of which is generally treatment expenses. In most cases, these expenses will have been absorbed by group insurance or Section B no-fault benefits.
Defences to Soft Tissue Claims
Insurers defend soft tissue claims based on the following types of arguments. These arguments are often supported by medical doctors who provide medical opinions for insurers. In more serious cases, insurers will conduct surveillance video recording.
- The impact between the vehicles was not sufficient to cause the degree of injury that the injured person is claiming.
- There is no objective proof that the injured person continues to suffer the effect of the injury.
- The type of injury would have healed shortly after the accident.
- The injury would not have caused the type of pain or limitation that the person is claiming.
- Surveillance video indicates the injured person performing an activity that he or she denied that he was able to perform.
- If the claimant had a previous accident, the insurer will argue that the injuries from that accident are responsible for any limitations.
- Most people eventually have degenerative disc disease. In fact, x-ray imaging will often only indicate degenerative disc disease. The insurer will argue that degenerative disc disease is responsible for the pain and limitations experienced by the claimant.
- The claimant's condition is psychosomatic. In other words, the underlying problem is due to emotion or stress or other subjective causes not related to the accident.
- The limitations experienced by the claimant are caused by pain. Pain is subjective and a self-limiting factor. If the claimant made a sufficient effort she would be able to continue her life as it was before the accident.
- The claimant is either lying or exaggerating about the effect of the injury.
- The claimant did not follow medical recommendations to reduce the effect of the injury.
Insurers attempt to use these defences to either avoid or reduce the compensation payable to the injured person.
Proving Your Soft Tissue Injury Claim
An experienced Newfoundland and Labrador personal injury lawyer like Geoff Aylward, Q.C. will provide you with valuable assistance in proving your claim and obtaining full and fair compensation. To maximize the effect of Geoff Aylward, Q.C.'s services, the client should also assist him by undertaking certain steps in his or her life during the course of the claims process.
Client Steps to Assist in Proving Soft Tissue Injury Claim
The following steps by you will help you prove your soft tissue injury claim.
- Seek medical attention when you first experience symptoms unless you are confident that the symptoms are minor and will resolve within a few days.
- Be thorough in describing to your doctor the symptoms that you have experienced.
- Follow all of the recommendations made by your doctor.
- Continue with your life as best you can.
- If your injury prevents you from performing certain work or other activities make your doctor or other healthcare provider aware of the difficulty that you are experiencing.
- Approach your health challenges proactively. If your doctor, healthcare providers and employers know that you are making a reasonable good effort to return to work and engage in other activities, it will make a favourable impression that will be reflected in the reports and evidence that is provided on your behalf. You may have to discontinue or reduce certain activities, but your efforts will provide proof of your limits and proof that you are a reliable, honest person trying your best.
Geoff Aylward, Q.C.'s Steps to Prove Soft Tissue Injury Claim
Experienced Newfoundland and Labrador soft tissue personal injury lawyer Geoff Aylward, Q.C. will take every reasonable measure to ensure you receive full and fair compensation. His part includes one or more of the following steps.
- Assistance in obtaining Section B no-fault benefits and in maintaining ongoing coverage for required health care treatment.
- Assistance and preparation for meetings with insurance adjusters.
- Keeping the insurer informed of what your claim involves so that it is easier to settle the claim once settlement discussions commence.
- Obtaining the medical and other evidence from treating health care professionals to document all treatment aspects of injury.
- Obtaining medical and other health care reports as required from your doctor and health care providers.
- Arrange for an independent medical examination and occupational therapy assessment.
- Taking all reasonable measures to validate the symptoms and limitations that have been caused by the accident.
- Preparing you for any required discoveries for the insurer. Nearly all claims settle without discoveries by the defence lawyer. If a defence discovery does occur it is a very good opportunity to properly and fairly describe your injuries and how your life has been affected. Following a positive discovery, most claims will settle.
Geoff Aylward, Q.C. uses the abbreviation OAR to describe in general terms the service he provides clients.
- Obtain relevant information, documents and evidence.
- Advise clients about the insurance, litigation and settlement process including preparation of client for each step of the process. Advise client about reasonable settlement outcomes and make recommendations to client about the advantages of settlement or taking further steps to move forward in the insurance and litigation process.
- Represent clients in communications with insurers, other lawyers and all persons involved in the decision-making process.
This approach ensures that the client has the opportunity to be fully engaged with the case or to trust the case entirely to the capable hands of Geoff Aylward, Q.C. Geoff works for the best settlement and outcome for each soft tissue injury client and respects that the client is the person at the center of the claim process. This ensures the best claim representation and full and fair compensation to soft tissue injury clients.
Resourceful, Compassionate Soft Tissue & Chronic Pain Lawyer in Newfoundland & Labrador
Persons who suffer soft tissue injury and chronic pain deserve effective legal representation. Sufferers require the full support and assistance of a fully qualified and respected personal injury lawyer. Geoff Aylward, Q.C. has vast experience handling claims like yours for more than 30 years. You can trust him for effective advice and representation so that you receive full and fair compensation for your injury. Contact lawyer Geoff Aylward for soft tissue injury and chronic pain injury representation today either online or at 709-726-7260.