I can’t tell you the number of times a new client has come to me, days, weeks or even months after their accident and said: “I didn’t know I was really injured.”
So many injuries don’t come up on a scan or x-ray; they’re not always immediately ‘visible’ and their lack of tangibility make them harder to assess, both from a medical perspective and a claim perspective.
But for you, the victim, this lack of visibility doesn’t make them any less real or painful.
Whiplash And Other Soft Tissue Injuries
Soft tissue injuries are diagnosed by symptoms such as range of motion limitations, headaches and dizziness and pain. The issue with these types of injuries is that the level of damage isn’t always quantifiable, and pain is very much a subjective issue.
Whiplash, for example, is a soft tissue injury that is common in car accidents because it’s the direct result of an impact throwing you violently from side to side, or backward and forward, exerting tremendous pressure on your head, neck and cervical spine area.
There are four levels of severity that range from minimal pain to fracture or dislocation. Most victims fall into the level 1 or 2 category, with the occasional 3 or 4.
Soft tissue injuries also include things like bumps, bruises and mild tearing of muscles, ligaments or tendons.
These types of injuries typically heal with treatment within 8-12 weeks. As a result, they don’t usually meet the threshold for filing a lawsuit in Ontario. Your pain would have to be chronic, with permanent impairment levels that prevent you from returning to your normal life.
However, if you’ve been diligently following your doctor’s treatment plan and still experiencing significant pain after 3 months, it might be time to talk to a personal injury lawyer: other more serious invisible injuries could develop or become more obvious over time.
Traumatic Brain Injury
One of those invisible injuries that might not be immediately apparent but could develop over time is TBI—Traumatic Brain Injury.
Imagine your brain is like Jell-O and your skull is the bowl. When you sustain an impact, like hitting your head on the headrest, the window, or another person, the Jell-O sloshes around in the bowl. This can cause the damage that we know of as TBI.
This kind of injury is, like soft tissue injuries, the result of an impact, which is why it often occurs as a result of a car accident. However, sports related injuries, a fall or other trauma can result in a TBI. And like other invisible injuries, they don’t always reveal themselves with MRI or CT scans.
The actual injury might be subtle enough at the beginning that you don’t even realize that you’ve had one. The first signs can be physical things like nausea, headaches or dizziness; they can also result in changes in your personality, like irritability or even aggressivity.
If you hit your head during the accident or don’t remember if you did but are exhibiting some symptoms, it’s worth being assessed by a neuropsychologist.
They can administer tests that will show whether your cognitive impairment is the result of psychological issues or a brain injury. When it comes to evaluating long term compensation, the distinction is important.
TBI is one of those injuries that may not come to light for quite some time after the accident, which is why it’s important to have a lawyer involved with your case from the beginning. As the injuries evolve and further evaluations are required, your lawyer can help you to make sure that you are on the right track if it turns out that you have a permanent cognitive impairment that affects your day to day living.
Post Traumatic Stress Disorder
PTSD—Post Traumatic Stress Disorder—can create a level of psychological pain that is hard to bear. But there is no way to empirically test for PTSD: no blood test, no scan; it’s another invisible injury that carries very serious consequences including the difficulty of obtaining compensation for loss of income and ongoing treatment.
There is hope, however! More is being understood about the impact of psychological trauma than ever before, and diagnosis by a qualified medical practitioner, while not done with a simple test, is also no longer dismissed as it used to be.
The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, fifth edition) has brought credibility to the main problem: the acceptable diagnosis of mental illness. Along with that credibility comes the ability to properly assess the impacts of mental illness, including the losses and expenses that come with it.
While every victim of a car accident will experience some level of stress or even anxiety when they get behind the wheel again, not every car accident victim has PTSD. There is a danger in overusing the term to describe every person who is uncomfortable or stressed for a time, when in or driving a car.
There are others, however, who experience the trauma of their accident in a far more profound way, psychologically. They might not be able to return to a sense of normalcy in their lives, whether in a vehicle or not.
In terms of the threshold, your injuries need to be a serious and permanent impairment to an important physical or mental function. That includes death, permanent and serious physical disfigurement or permanent and serious physical or mental impairment.
With invisible injuries, the trauma inflicted by psychological scars are difficult to measure and even more difficult to put a dollar figure on, but the courts are warming up to the idea of lifelong psychological disability when evaluating ‘pain and suffering’, and what that adds up to, in terms of compensatory damages.
Working with a lawyer from the beginning will make it easier to assess all of your injuries, visible and less so, and their impact on the rest of your life.