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Case study 029/18

Introduction

The claimant was a passenger in the front seat of a vehicle that was hit by another vehicle on the right front side in a “T-bone” fashion.

The claimant did not experience a loss of consciousness, however felt immediate pain in the chest and back. An ambulance transported the claimant to hospital from the scene of the accident.

Physical examination and x-rays performed at hospital did not detect any fractures. The claimant was discharged with instructions to see a General Practitioner.

The claimant returned to work the following week and worked for three non-consecutive days, but found that persistent symptoms of pain made it unable to continue working. The claimant has not returned to work since this date.

The claimant became immediately afraid of driving or being in a car. The persistent symptoms of pain led to poor sleep and irritability.

Two weeks after the subject accident, the claimant was referred to a psychiatrist, following which antidepressant medication was prescribed.

Clinical Examination

Pre-MVA

  • In fulltime work for 15 months
  • Felt happy and well from a psychological perspective
  • Responsible for own self-care
  • No problems with memory or concentration
  • Enjoyed regular social life with friends

At Assessment

  • Low mood
  • Loss of employment
  • Reported suicidal ideation
  • Sleep interrupted frequently by symptoms of pain
  • Loss of motivation and libido
  • Remains anxious about driving, however will travel as a passenger if necessary
  • Reduced social interaction with friends
  • Finds it hard to focus and is easily distracted
  • Sometimes will not shower and will wear the same clothes for consecutive days
  • Increased food intake, leading to weight gain

The claimant reported persistent symptoms of anxiety and depression on the background of chronic pain. The claimant did not report sufficient neurovegetative symptoms to suggest the presence of a Major Depressive Episode.

The Assessor diagnosed the claimant with an Adjustment Disorder with Mixed Anxiety and Depressed Mood, in response to involvement in the accident and symptoms of chronic pain that have been experienced thereafter.

An Adjustment Disorder with Mixed Anxiety and Depressed Mood is considered a minor injury for the purposes of the Act.

Based on the history provided by the claimant and the medical information available to the medical assessor, the following injuries were determined to be caused by the motor accident

  • Adjustment Disorder with Mixed Anxiety and Depressed Mood

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

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).