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In the News: Developments in Depression

Wednesday, June 27th, 2012

Depression can happen as the result of a traumatic experience. Long term depression can make it difficult to perform the duties of day to day employment and activities of daily life.

Researchers in Copenhagen have discovered that plant compounds from South African Daffodils may in time be used for treatment for depression. The plant compounds seem to be able to pass through the blood brain barrier, which is a significant finding. Typically, drugs for “diseases of the brain” are not able to pass the blood-brain barrier.

There is a new research network in Ontario attempting to boost efforts for treating depression. A former lawyer, Phil Upshall, profoundly affected by mental illness and a neuroscientist from the University of Ottawa/ Royal Ottawa Mental Health Centre have joined forces and made a pitch to the federal Conservative government with their proposal for a new research network of 80 scientists working together to find ways to help Canadians with depression. The government granted a $5 million dollar initiative, for the Canadian Depression Research and Intervention Network. This is a recognition by the government that mental illness and depression is a serious issue in Canadian society.

The network will focus on youth suicide and post traumatic stress disorder. According to Mr. Upshall, suicide is the leading cause of death in youth after motor vehicle accidents. PTSD is an anxiety disorder but it is also linked to depression, amongst other factors.

CBC.ca recently posted an article stating that teens and youth with anxiety and depression in Ontario can have faster access to mental health care and can skip doctor referrals. Up to a quarter of teens and youths experience anxiety, depression and other forms of mental illness that go undetected due to the long wait times to see specialists.  The London Health Sciences Centre is offering a program where youth between the ages of 16-26 can pick up a phone and get a mental health assessment, thereby bypassing the need for a referral or long waiting list. Early treatment can prevent mild or moderate illness from becoming more serious.

Did you know that how you use the Internet is a reflection of your mood? Internet use can be a sign of whether or not you are depressed, according to a recent study. Time Magazine recently posted an online article about this, “The Internet Knows You’re Depressed, But Can It Help You?”.  The study examined the internet use of college students and tracked their behaviours. Depressed students typically compulsively check e-mail, watch many videos, spend a lot of time playing games and chatting, and frequently switch back and forth between applications. 30% of the students had low mood, symptoms of anxiety and difficulty with concentration.

Did you know that chronic stress blocks a gene that guards your brain from depression? It turns out that chronic stress appears to block a gene that guards against brain atrophy associated with depression.  The gene is known as Neuritin and appears to be responsible for maintaining healthy connections in particular parts of the brain. The study is published in the Proceedings of the National Academy of Sciences. Rats, whose genes were suppressed, were found to be more anxious and depressed. Activating Neuritin led to an antidepressant response. This research adds evidence to the idea that depression may result from atrophy in the hippocampus, that brain’s centre responsible for mood and memory.

Aaron Waxman and Associates is a Personal Injury Law Firm in Toronto that handles only personal injury claims. We handle long term disability claims. If your claim for long-term disability has been denied, contact us today.

 

 

Difficulties in the land of Accident Benefits

Sunday, June 10th, 2012

Recently, Ontario’s Standing Committee on General Government held public hearings on Ontario’s auto insurance industry practices in Queen’s Park. This committee doesn’t have the power to make changes, but it has the power to recommend them.

The Committee heard from the Insurance Industry, health professionals, personal injury lawyers, Financial Services Commission of Ontario (FSCO) and the Auto Insurance Anti-Fraud Task Force

Personal Injury Lawyers in Ontario can certainly speak to a number of growing concerns when it comes to auto insurance. Especially since the September 1, 2010 reforms.

Accident victims have to contend with the Minor Injury Guideline and a maximum of $3500 of medical/rehabilitation benefits.

Insurance adjusters must provide a medical reason for denying a treatment plan. But why are they being allowed to make medical decisions?

The accident victims who are denied treatment, whose rehabilitation is put on hold are at a serious disadvantage.

It certainly seems as if more and more treatment plans are being denied. And with the MIG in existence, it is harder for people who are placed in that category to achieve full recovery if they require further treatment after the $3500 has run out.

Applying for mediation is they way to appeal an insurer’s decision, however there are over 30,000 applications waiting to be processed and mediated at FSCO. That is very telling.  It is estimated that an additional 3000 applications are being submitted each month.

And what might these applications be for? Denials of benefits – medical benefits, weekly benefits, attendant care benefits, housekeeping benefits….benefits accident victims require to recover and rehabilitate.

Legislation requires that FSCO mediations are to be completed within 60 days of the filing of an application. The reality now is that mediations are taking place 10 to 12 months later, or even longer.

So what did the Insurance Bureau of Canada (IBC) have to say to the Committee?

According to an article posted on CanadianUnderwriter.ca   IBC’s VP for Ontario, Ralph Palumbo said “While the September 2010 reforms were a needed first step in reducing the pressure on no fault injury costs, claims costs are still out of control..”

Mr. Palumbo listed the following reasons for high costs:

1.Mediation Backlogs

2. Increase in Catastrophic Injury Claims

3. Increase in Bodily Injury Costs

4. Persistence of Auto Insurance Fraud

 

With respect to catastrophic injury claims, Palumbo noted that hospitalizations from car accidents decreased by 12% while the number of CAT claims increased.

He further noted that  on the tort side of things, bodily injury claims are increasing drastically. Both the frequency and cost of these claims has been rising. BI claims represent more than $2 billion in annual costs.

Palumbo had this to say: “BI is on the same track accident benefits were before the 2010 reforms and more needs to be done to assess the causes and what can be done to alter this concerning trend.”


Aaron Waxman & Associates is a Toronto Personal Injury Law Firm dedicated to serving the needs of their clients.

 

 

 

In the News: Brain Injuries

Tuesday, May 15th, 2012

A Traumatic Brain Injury occurs when something outside the body hits the head with a significant force. The recent suicide of former pro football player, Junior Seau rekindled the debate on “unseen” injuries in football. These “unseen” injuries are now being classified by the CDC as traumatic brain injuries.

A traumatic brain injury can be the result of a car accident, from a fall, sports injury or other recreational activities or trauma from a blast or explosion (combat).

A TBI can cause changes in a person’s ability to think, control emotions, walk, speak, or even affect his or her sense of sight or hearing.

In the US and in Canada. TBIs are happening in epidemic proportions.

A recent article commented that “combat and football are not that different”, meaning that the potential for brain injuries are similar as are their consequences.  Troops returning from Iraq and Afghanistan bear the outward signs of injury from  combat, but they also bear the “unseen” injuries” of post traumatic stress disorder (PTSD), depression and TBI.

The CDC reports that car accidents are the leading cause of death amongst teenagers. The National Institute of Health says that teenagers and children are more susceptible to brain injuries and concussions as their brains are still developing. Young brains are also more likely to suffer long-term neurological and psychological disabilities that can affect social and cognitive skills, as well as family relationships, for years to come. As the brain is the most difficult organ to heal in the body, the road to recovery is long and often very costly.

Dr. Charles Tator, concussion and brain injury expert made a definite statement about the game of hockey: “We have no treatment for concussions…We have no treatment for the accumulative concussion, we have no treatment for the repetitive concussion, and it is the repetitive concussion that causes brain damage.Let’s get head shots out of hockey.”

The admission that there is no treatment for concussions is enough to carry out the debate on head shots throughout the summer. The statement comes at a time when over 1000 former NFL players are suing the league.

A U.S. study has found that female and younger athletes show more symptoms of a concussion and take longer to recover from its effects. The research comes out of a study from Michigan State University and suggests that physicians now take age and gender in mind when treating an athlete that has suffered a concussion. Canadian experts in concussions have been agreeing with the study and have also been finding that women have a higher mortality rate following severe traumatic brain injuries, outcomes seem to be worse and recovery seems to take longer than men.

Concussion risk may be influenced by gender, age, neck strength/weakness, reaction time and symptom reporting. The developing brain of younger athletes should be treated differently than adults. Experts say that each case should be treated differently.

Aaron Waxman and Associates handles traumatic brain injury injury claims. Contact us today for a free consultation.

Drive Safe This Long Weekend

Tuesday, May 15th, 2012

As the Victoria Day Weekend approaches and people get ready to go to their cottages and go away for the long weekend, the OPP remind everyone to exercise caution with driving and avoid driving while under the influence of alcohol and drugs.

This week, the OPP launched their Safety Week, a province wide blitz for Ontario that began on Monday May 14, 2012.

Police want the public to be aware that they are on the lookout for bad driving habits and safety concerns. They are looking for the main contributors to serious and fatal accidents: aggressive, impaired & distracted driving.  Officers are also checking to see that everyone is wearing their seat belts.

If you have been involved in a car accident, contact Aaron Waxman and Associates for a free no obligation consultation. We can help you during your difficult time.

Developments in Chronic Pain

Wednesday, May 2nd, 2012

Canadians deserve a National Pain Strategy: this is the latest message from the Canadian Pain Coalition. On April 24, 2012 in Ottawa, stakeholders met to discuss the issue of pain at the first ever Canadian Pain Summit. Pain is one of the most common reasons for an individual to contact a doctor yet many studies conclude acute and chronic pain is not well managed. Society does not acknowledge how widespread the issue of chronic pain is. There are 6 million Canadians who suffer from chronic pain from car accidents, workplace injuries, illness, arthritis, cancer patients and veterans. The National Pain Strategy is a call to action to address to social, economic and personal impact of pain on Canadians. The strategy identifies 4 key areas:

1. Awareness and Education

2. Access

3.Research

4. Ongoing Monitoring

Pain costs the economy $56-60 billion in lost wages and direct health care costs, additionally, each individual pays $17,554 for costs not funded by insurance or publicly.

One in three adults with arthritis have anxiety or depression according to researchers from the Centre for Disease Control and Prevention.  A new study suggests that patients with arthritis should be screened for anxiety and depression. In the United States alone, 27 million people age 25 and older have osteoarthritis, and 1.3 million adults have rheumatoid arthritis, according to the American College of Rheumatology. Anxiety was found to be more prevalent than depression amongst people with arthritis. It has been said that heath care providers can make a difference by treating their patients for depression and anxiety and addressing these areas of concern.

A recent article commented that patients with lower back pain have a poor prognosis. It appears that episodes of low back pain return after six months in more than 50% of people and in the subsequent 18 months in 47% of people.

A large study was conducted that demonstrated how “junk food” is linked to depression. The study consisted of 9000 adults in Spain.  Consistent consumption of “fast food” and commercially basked foods and products like croissants and donuts increased the risk of depression. Depression affects 121 million people worldwide.

 

 

Developments in the Field of Depression

Tuesday, April 17th, 2012

Depression is not just a mental illness, it is a whole body illness. In a recent article, “Depression- A Whole Body Disorder“, it is revealed that research shows that depression and other psychological disorders affect the body just as much as they do the mind.

Researchers are starting to view depression as a whole-body, rather than strictly brain-based illness. New research has established that young people who suffer from long-term psychological stress, depression or Post Traumatic Stress Disorder tend to develop physical conditions typically associated with adults, namely stroke, dementia, heart disease and diabetes. Scientists are studying depressed people on a cellular level. They are finding the same changes to chromosomes that occur in people as they age can also be found in people dealing with major stress and depression.

These chromosomal changes are known as “accelerated aging” and this phenomenon is changing the way people in the field of mental health view depression: it’s beginning to be thought of as a systemic illness rather than a mental illness.

A study is being conducted on deep brain stimulation and its use in patients with major depression.

BROADEN™ (Brodmann Area 25 Deep brain Neuromodulation) is the first randomized clinical research study to investigate Deep Brain Stimulation (DBS) as an intervention for patients diagnosed with unipolar major depressive disorder (excluding bipolar disorder) who have not improved after multiple treatments.

DBS is a therapy that uses mild pulses of current (stimulation) to regulate specific areas of the brain, the same way a pacemaker uses pulses of current to regulate the heart.

In this study, stimulation is being delivered to an area of the brain known as Brodmann Area 25, which is believed to function differently in people with major depression and appears to be overactive when people are profoundly sad and depressed.

Dr. Sanjay Gupta of CNN also discusses DBS as a therapy in an article called “Treating Depression with Electrodes Inside the Brain”. DBS actually involves drilling two holes into the skull to implant 2 battery powered electrodes deep inside the brain. DBS targets a very specific structure, Area 25 that is thought to be the ringleader of what controls our moods according to neurologist Dr. Helen Mayberg. Her research showed that Area 25 is overactive in depressed patients. DBS has been used as treatment since 1997 in patients with movement disorders such as Parkinson’s disease and essential tremor. Dr. Mayberg worked with a Toronto neursurgeon, Dr. Andres Lozano with her first group of implant patients and published her study in 2005. DBS has given patients hope for depression.

Transcranial Magnetic Therapy is another type of therapy that is used to treat extreme cases of depression. It was first approved by the FDA in 2008. According to this Chicago Tribune article, the therapy entails having a device delivers small electric pulses to nerve cells in the emotional regulation centers of the brain through a wire coil wrapped around the patient’s head. The patient sits  in a comfortable chair for the duration of the treatment, which is approximately 37 minutes. It is recommended to have 20-30 sessions over a four to six week time span.  Side effects include tingling of the scalp and headache.

Aaron Waxman and Associates is a Toronto Personal Injury Law Firm. We practice personal injury law and handle long-term disability claims. If your claim has been denied, contact us for a free consultation so we can assist you to know your rights.

 

In the News: Concussions

Sunday, April 15th, 2012

Concussions. An invisible injury that has long lasting consequences.

Concussions are garnering a lot of attention in the news over the past year or so due to Sidney Crosby and all the other concussed hockey players and major league sports players.

Before the start of the NBA season, a new concussion protocol was launched. The league has a concussion program director. Each player’s neurological baseline is studied before the beginning of the season. After a concussion, a player’s neurological baseline is compared to the initial test and the player has to return to his original neurological baseline in order to return to play. A series of tests are done to test exertion and if a player remains symptom free after these tests, he can return to play.

High schools in the United States are experimenting with using a new helmet cover developed by The Hanson Group in Georgia and Protective Sports Equipment in Pennsylvania. The helmet cover, nicknamed “the Guardian”, has 37 gel-filled pouches that fit over a helmet and cushion against helmet-to-helmet blows that are so dangerous that the NFL aggressively penalizes them.

The NFL’s helmet sponsor Riddell tweaks the padding and design of its equipment on a regular basis. Xenith LLC’s line of helmets use air-filled pads rather than foam. Other companies are testing more dramatic changes.

A New York-based startup company called Thermopraxis and Schutt Sports – the largest producer of football helmets – are working on a product called the Thermocrown. The Thermocrown is a bladder that can fit inside a player’s helmet. It is based on an idea developed by Renato Rozental, a Brazilian neuroscientist. The idea of the Thermocrown is that in the event of a hard hit to the head, a trainer or teammate would be able to attach a source of cooling gas to the bladder in the helmet to lower the head’s temperature and stave off damage, having a similar effect to applying an ice pack.

This concept can buy time, up to four to five hours to allow the hurt player to be taken off the field and transported to a hospital.

An independent industrial design engineer, Michael Princip is developing the Bulwark, featuring multiple plates on the helmet’s exterior, to mitigate the impact of big hits and frequent smaller ones that are part of the football games.

Hundreds of former NFL players are suing the NFL and helmet maker Riddell in the wake of a growing evidence connecting repeated blows to the head and long-term brain damage. Reported symptoms include short term and long term memory issues and depression and behavioural changes.

They say the league didn’t do enough to inform players about the dangers of head injuries and protect them from concussions in the past, and it isn’t doing enough to take care of them today. At the very least, these lawsuits brings awareness to the fore and they are about education and awareness down to the level of highschool football leagues and young football leagues.

The Youth Sports Concussion Program is the first program in Canada to create a standardized model for how primary care providers “diagnose, assess, treat and manage concussions.” It is being used in Peterborough, Ontario.

Family doctors and nurses are able to manage concussions without patients needed to go to the emergency room through the use of several tools and techniques compiled by the program. The program also focuses on concussion awareness through an education component by going to schools throughout Peterborough to educate youth about the seriousness of a concussion.

The program makes use of something called Axon Sports’ Computer Cognitive Assessment Tool. It’s a 10-minute-long online test that measures a person’s working memory, attention, learning and ability to process information in a set time frame . These are four skills that can be affected by concussions.

Young athletes take the test before their season begins to set a benchmark for their abilities. Should they be injured, they retake the test and compare the results. Comparing the test results is important because cognitive recovery takes longer than physical recovery. Most kids would try to play through a concussion and insist they are okay to play, this way, using a baseline study, there is a way to determine their level of functioning.

Aaron Waxman and Associates is a personal injury law firm that handles personal injury claims in Ontario. We handle serious injury claims and brain injury claims. Contact us today for a free initial consultation.

 

 

Ontario Budget Revealed: What it Means for Personal Injury Law

Wednesday, March 28th, 2012

On March 27, 2012, the Ontario provincial budget was released. This report includes changes to the definition of catastrophic impairment and enforcement to reduce auto insurance fraud.

The Insurance Bureau of Canada is of course applauding the fraud measures proposed in the budget and the administrative penalties recommended.

On September 1, 2010 the government made major changes to Ontario’s auto insurance system. The government feels that premiums are stabilizing for drivers across Ontario. Building on the success of these reforms, the government wishes to take action to tackle fraudulent and abusive practices, base insurance benefits on scientific and medical principles, and ensure its regulator continues to identify and respond to new and emerging issues.

Auto Insurance Anti-Fraud Task Force

The government is committed to combating insurance fraud and continues to support the Auto Insurance Anti-Fraud Task Force who issued an interim report in December 2011 and the government has already:

  1. enhanced auto insurance fraud training for police officers;
  2. started a pilot project using the Health Claims for Auto Insurance database, which will allow health care providers to flag clinics that are misusing their credentials and cut down on identity theft;
  3. amended regulations to ensure that treatments are provided as invoiced;
  4. issued a Superintendent’s Guideline to ensure that insurers are not being involved for medical devices at a significantly higher than market rate;
  5. encouraged the industry to communicate the issue of fraud across a number of media platforms, and measure the current state of consumer engagement and awareness on the issue; and
  6. required CEOs of automobile insurers in Ontario to annually attest that their accident benefit cost controls are effective and that legitimate claimants claimants are treated fairly.

The Task Force recommended that the government should provide that the Superintendent of Financial Services with the power to impose administrative monetary penalties for contraventions of legislation and regulations. The government is proposing amendments that will provide the authority in order to enhance regulatory effectiveness.

Scientific and Evidence-Based Approaches:

What does the government mean by basing insurance benefits on scientific and evidence based approaches? This is a reference to accident benefits of course.  The report mentions that scientific and medical knowledge with respect to identifying and treating “a variety of injuries” has improved “remarkably” over the past decade and states that “The government will ensure, where possible that insurance regulations reflect the most relevant science on identifying and treating injuries from automobile accidents”.  This apparent clarity will help minimize disputes over benefits and ensure people get the treatment they need and ensure treatments are based on medical evidence.

The report goes on to say that newer scientific and evidence-based approaches can be applied to serious and minor MVA injuries.

There are recommendations that a new Minor Injury Guideline be developed.

The government received the Superintendent of Financial Services Report with respect to Catastrophic Impairment (based on the work of an expert panel) and will move forward to propose regulatory amendments in this area.

The report is to be made public in the coming weeks. The question is, will the report mirror what the expert panel said? Will Superintendent Phil Howell’s report differ? Two big concerns that the Plaintiffs’ bar has is whether or not the combining of physical and psychological impairments will be allowed to determine catastrophic determination and the use of the Glasgow Coma Scale. To learn more about the proposed changes, refer to our earlier post about the changing definition of catastrophic impairment found here.

Modern Insurance Regulation:

FSCO, the Financial Services Commission of Ontario is to modernize to meet current challenges. The government proposes to enhance FSCO and its regulation of the insurance sector by proposing to:

  1. engage in a review of the automobile insurance dispute resolution system;
  2. strengthen the Superintendent’s authority regarding Unfair or Deceptive Acts or Practices;
  3. clarify the Superintendent’ s authority regarding rate and risk classification approvals;
  4. support a Superintendent’s review of the profit provision benchmark in auto insurance rate change approvals;
  5. work with insurers to explore the implications of voluntary usage-based auto insurance policies;
  6. harmonize the timing of statutory automobile insurance reviews; and
  7. improve solvency supervision of Ontario insurers.

The new Budget also noted the Ontario government’s intention to review and update the Insurance Act:

  1. the government is proposing amendments to the life insurance and accident and sickness insurance parts of the Insurance Act to enhance consumer protection, reduce regulatory burden and harmonize with other Canadian jurisdictions; and
  2. the government is enhancing the effectiveness of its insurance regulation by proposing amendments to give the Superintendent of Financial Services the authority to impose administrative monetary penalties in the insurance sector.

Checking in with your Insurance Needs

Thursday, March 22nd, 2012

Are you ready for life’s unexpected curveballs?

How would you manage financially if you were diagnosed with a serious illness and were unable to work? Or suffered a serious injury that rendered you unable to work?

Changing lifecycles are changing insurance needs. People are living longer, supporting adult children and are more active later in life compared to previous generations. The average life expectancy for men and women has increased. Due to medical advancements, more and more people are surviving critical illnesses.

Another change that has been happening is that people are choosing to have children later in life. Statistics Canada has revealed that more women are giving birth in their 40s.

What does this mean? Critical illness insurance is becoming more and more important. Why? It protects a family’s income and savings.  It protects a business person’s income and savings.

Having adequate insurance is important if you are self-employed or have a family or are planning to start a family. The sooner you obtain insurance, the better your premiums will be given your age, and it reduces the risk of being declined for coverage due to health issues.

To read more about the changing need for insurance, read the press release, “70 is the new 50″  issued by TD Insurance found here.

A recent article in the Globe and Mail, called “Lessons learned from a tragic game of touch football” also visited the necessity of critical illness and financial preparedness.  Changing work and family dynamics have made protecting income and finances necessary, especially as the health-care system deals with an aging population that is living longer and the federal government discusses possible changes to Canada Pension Plan and Old Age Security.

 

There are growing numbers of people who are self-employed or who have contract jobs, or are employed without benefits and insurance plans that supplement or protect their income and assets.

Critical illness insurance is a very important product. It’s been available in Canada since 1996. Consider the following:

  1. 1 in 3 Canadians will develop cancer
  2. 1 in 2 heart attack victims is younger than 65
  3. 3/4 of the 50,000 Canadians who suffer from a stroke annually will be left with a disability

Critical illness insurance pays a lump sum amount if the policy holder is diagnosed and meets the survival period. The general idea is that the lump sum covers the amount of income that may be lost while the person is off work for treatment or recovering. It can also offset the cost of private nursing care, attendant care, medications or other such needs.

Aaron Waxman & Associates handles critical illness insurance claims. In the event that your claim is denied, contact us for a free consultation.

 

 

 

 

 

Social Media and Personal Injury Cases: LTD Benefits

Tuesday, March 13th, 2012

We recently blogged about social media and personal injury cases. Insurance companies are using social media as a means of surveillance to try to find out more about a claimant’s character, and their credibility.

At discoveries, defence lawyers are asking for plaintiffs to produce their Facebook photos, or preserve their accounts. The requests for access to plaintiffs’ and claimants’ social media sites are not going to disappear as more and more people are joining these sites.

But how much do these social media sites tell about a person??

Consider a Quebec woman’s fight with her long-term disability insurer made headlines late in 2009. The headlines were essentially “Depressed woman loses benefits over Facebook photos”.

Nathalie Blanchard, an employee of IBM, went on sick leave for major depression and was being paid long-term disability benefits through Manulife Financial for a year and a half. She attended therapy, took prescription medications, and then her doctor suggested that she take a trip and try to enjoy herself, so she booked a trip, she notified her insurance company and she took pictures of her trip.

She posted those trip pictures on Facebook. It turns out Manulife had their eye on her Facebook account and noticed her photos and determined she did not appear depressed in her photos.

When her benefits cheques stopped coming, she called Manulife and asked why. Manulife described her Facebook pictures to her and told her that is evidence she is no longer depressed. She doesn’t understand how Manulife accessed her photos when her profile is private.

She retained a lawyer to sue Manulife and have her benefits restored, her lawyer felt Manulife’s actions were inappropriate.

It is important to consider the fact that depression and mental illness aren’t visible illnesses like physical injuries. A picture doesn’t necessarily capture a person’s state of mind.

Manulife felt that Blanchard was well enough to work based on her pictures.

Manulife would not comment specifically on Blanchard’s case but said they would not deny or terminate a valid claim based solely on information found on sites such as Facebook. A spokesperson for the Canadian Life and Health Insurance Association said “We can’t ignore it, wherever the source of the information is..”

The case is before the courts now.