SIRA Logo

Case study 36 - minor injury

Overview

This case study explores a dispute about whether injuries (cervical, thoracic and lumbar spine) are minor injuries under Schedule 2 section 2(e) of the Motor Accident Injuries Act 2017 (the Act).  The Assessor found that claimant’s injuries satisfy the definition of Minor Injury.

Introduction

The claimant was the driver in a motor vehicle when they were hit in a roundabout on the driver’s side with considerable force. The claimant’s vehicle was spun 180° and was subsequently “written-off”. A few days later, the claimant reported suffering severe pain in the neck, cervical and lumbar spine at which time they attended their general practitioner and were referred for a bone scan, physiotherapy and provided analgesic medication.

The Assessment

There is a dispute about whether the injury is a minor injury under Schedule 2 section 2(e) of the Motor Accident Injuries Act 2017 (the Act).

Clinical Examination

Cervical Spine

  • There was a decrease in right rotation, all other movements were normal
  • No muscle spasm noted, nor spinal contour
  • No evidence of upper limb radiculopathy

Thoracic Spine

  • No tenderness on palpation
  • No muscle guarding, nor spasm or loss of the normal thoracic kyphosis
  • There was no paraspinal muscle spasm or loss of movement

Lumbar Spine

  • Noted tenderness in the midline of the lower lumbar region
  • Flexion was half range, extension was to a third of normal and rotation was half normal range
  • No flattening of lumbar lordosis nor muscle spasm present
  • No other abnormalities were noted in the spine

Upper Extremities

  • Full range of movement in the right and left shoulders, wrists and elbows demonstrated
  • Power of grip and pinch were normal in both hands
  • No loss of sensors and no alteration of normal reflexes

Lower Extremities

  • Reported pain in the right knee, despite normal range of motion
  • No joint crepitus or joint effusion or instability
  • Other joints in the lower extremities were normal
  • No loss of reflexes or sensory changes noted
  • Measurements at the thigh and calf confirmed no muscle wastage present

Review of Documentation

Physiotherapy reports over the past 4 months indicate that the claimant was suffering neck and back pain with an inability to drive long distances.

Bone scans 2 weeks post-accident (to confirm or deny fracture) confirmed facet joint arthritis in the lumbar spine at L2/3 and L3/4 and early mild degeneration in the hands, wrists, shoulders, hips and knees. However, no skeletal abnormalities were reported.

Diagnosis

Cervical Spine – soft tissue injury without evidence of referral to other extremities.

Thoracic Spine – there are no clinical findings nor signs of injury and therefore this injury has resolved.

Lumbar Spine – the claimant noted ongoing pain and asymmetrical range of motion with no evidence of radiculopathy and is therefore considered to have a soft tissue injury.

Minor Injury

Section 1.6(2) of the Act

A soft tissue injury is (subject to this section) an injury to tissue that connects, supports or surrounds, other structures or organs of the body (such as muscles, tendons, ligaments, menisci, cartilage, fascia fibrous tissues, fat, blood vessels and synovial membranes), but not an injury to nerves or a complete or partial rupture of tendons, ligaments, menisci or cartilage.

Schedule 1 [2] clause 4 of the Motor Accident Injuries Regulation 2017:

  1. An injury to a spinal nerve root that manifests in neurological signs (other than radiculopathy) is included as a soft tissue injury for the purposes of the Act.

The claimant was assessed as having no injuries that have resulted in a complete or partial rupture of the soft tissues and displayed no evidence of radiculopathy consistent with a significant nerve injury. The injuries to the neck, thoracic and lumbar spine are therefore minor injuries.

The following injury is a minor injury

  • Cervical Spine – soft tissue injury
  • Thoracic Spine – soft tissue injury (resolved)
  • Lumbar Spine – soft tissue injury