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Case study 27 - injury to cervical spine

Overview

This case study explores a dispute about whether an injury (to the cervical spine) is a minor injury under Schedule 2 section 2(e) of Motor Accident Injuries Act 2017. The Assessor found the one of the claimant’s injuries satisfies the definition of a Minor Injury, and the other was assessed as a Non-Minor Injury.

Introduction

The claimant was driving with family member as passengers.  While waiting to turn their car was rear ended and then hit two cars into ongoing traffic.

The claimant reported neck, right shoulder pain and anxiety with driving.  They also reported being withdrawn, more tearful, stopped going out with friends and driving.

The claimant had nine sessions psychology counselling, which helped, however they remain very anxious when driving.  They can now drive around the local area, but due to anxiety and panic symptoms they have reduced activity and attendance at social events.

The Psychological 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).

Pre-MVA

  • No documented history of psychiatric illness
  • Able to drive independently

Clinical examination

  • Well groomed
  • Speech normal rate and flow
  • No impairment on cognitive testing
  • Reduced social interaction with friends and family
  • Limited driving due to anxiety and panic symptoms
  • Relationships with family are strained
  • Low mood and tearfulness

Review of Documentation

GP medical certificate outlined an initial diagnosis of psych – acute stress.  Updated diagnosis of Adjustment Disorder with mixed symptoms of anxiety, flat mood and poor sleep.

Diagnosis

Claimant has the following psychiatric conditions according to DSM-5 criteria:

  • Adjustment Disorder with Mixed Anxiety and Depressed Mood
  • Specific Phobia – situational (of driving a motor vehicle)

The severity of the claimant’s phobic symptoms of driving a car are such that they cannot be subsumed under the diagnosis of Adjustment Disorder with Mixed Anxiety and Depressed Mood and require a separate psychiatric diagnosis according to DSM-5 criteria.

Minor Injury

Section 1.6(3) of the Act:

A minor psychological or psychiatric injury is a psychological or psychiatric injury that is not a recognised psychiatric illness.

Part 1 clause 4 (2) of the Motor Vehicle Injuries Regulation 2017:

2) Each of the following injuries is included as a minor psychological or psychiatric injury for the purposed of the Act

a) acute stress disorder

b) adjustment disorder

3) In this clause, acute stress disorder and adjustment disorder have the same meanings as in the document entitled Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

The following injury is a minor injury

  • Adjustment Disorder with Mixed Anxiety and Depressed Mood

The following injury is not a minor injury

  • Specific Phobia – situational (driving a motor vehicle)