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Dizziness and nausea.
- Will ICBC believe me when I tell my doctor that I have felt dizzy, light-headed and off balance since my car accident?
- ICBC and a judge or jury may not believe that you have a serious dizziness problem from your accident unless at least a few scientific tests of your balance system support your complaints. Ear specialist will perform a number of tests. Some family doctors are also able to do a few simple tests. It may also be beneficial for your lawyer to send you to a top notch ear specialist who is very experienced in testifying in legal cases.
Do you suffer from symptoms of dizziness and light-headedness after a car accident? Call us now at 604-200-5965 or email us.
- Do doctors know why people who have been injured in vehicle collisions get dizzy and nauseous when there is a lot of movement around them?
- A leading Vancouver ear specialist had the following to say about a patient with dizziness after a motor vehicle collision:
"Visual Vestibular Mismatch refers to a condition where the patient develops symptoms which are distressing and bothersome. Anyone who has been sitting at a traffic light on an incline and suddenly notices that they are falling back down the incline and rapidly slams their foot on the brake has experienced a situation where a car next to them is in fact moving slowly forward. They misinterpret this and think that they are going backwards. This is a visual vestibular mismatch situation. The individual has had an awareness of visual information misinterpreted into the feeling that they are moving. This is a physiological visual vestibular mismatch. "
"The condition of visual vestibular mismatch which is abnormal or pathological is of similar distressing symptoms induced by a situation where normal people do not get symptoms. Where there is a lot of movement around the individual, this causes confusion, distress and dizzy symptoms. The reason for these dizzy symptoms is that the information from the balance system of the ear, as the patient is moving, does not synchronize or mesh with the information that the patient receives from his own vision. This results in awareness that there is a difference between the two and a sensation of dizziness is produced. Particular situations where this occurs are ones with a lot of movement. Characteristically rippling water and also the standard situation of a lot of movement in a supermarket or shopping mall produces awareness of dizziness. People around the patient are moving relatively indiscriminately and this results in a dizzy sensation. Onset of these symptoms subsequent to his accident and their absence prior to the accident means that, in my opinion, the accident is the probable cause. "
"The balance system, when it is malfunctioning, causes a number of symptoms. It causes a disturbance of eye movement which can be felt as vertigo as the eyes move inappropriately. At this point, the patient's conscious level is alerted to the difficulty with the awareness that they have dizziness. This can be in milder form so that the sensation is light headed, spaced out, rather than acute vertigo. "
- What tests prove that I am having the dizziness I experience?
- A number of tests may be performed, but tests alone are not enough. Your physician or specialist must also take a detailed history of your dizziness.
Some tests have extra value legally because they give strong objective evidence that you are not exaggerating and that there is a physical basis to your dizziness. The EquiTest is an example of such a test. There is currently only one place in British Columbia where you may take this test—Vancouver General Hospital. If appropriate, lawyers may pay to have this test done quite quickly.
The patient stands on a moveable platform surrounded by a moveable screen. The patient wears a harness that will safely break a fall if he or she loses balance. During the test, the platform and/or the screen move, and the patient's ability to maintain balance is measured. Patients often produce characteristic results on this test if they have a balance system disorder. One of the tests on the EquiTest is accepted by Ear, Nose and Throat specialists as a valid test for determining if a patient is exaggerating. Exaggeration is always an ICBC argument or suggestion in an ICBC claim for "invisible injuries," so it is important to dispel this notion.
The EquiTest will also determine if the patient's disorder is located in the inner ear.
Some of the other medical tests used are:
- hearing tests (as the balance system is located mainly in the inner ear)
- walking a straight line
- touching a finger to the nose
- standing on one foot for a certain number of seconds
- the Romberg Test: Patients stand with their feet together and their eyes closed. The physician often pushes patients slightly to see if they are able to compensate and regain their posture.
- Dix-Hallpike test: A patient is brought from a sitting position to a lying position with the head tilted to one side and backwards. The physician then looks to see if the patients' eyes jump.
- Electronystagmography (ENG): During one part of this test, water is put in the patient's ears and movements of the patient's eyes are recorded. Often this test shows nothing abnormal. A normal result will most likely not harm your case or diagnosis as the ENG tests only part of the balance system.
Need help proving dizziness to ICBC after your car accident? Call us now at 604-200-5965 or email us.
- What if no balance tests give a positive result?
- The tests for dizziness often do not give positive results for patients who have a significant cause for dizziness. If no test is positive but the specialist has taken a detailed history from you, the specialist may then say that many of your complaints are consistent with a certain type of balance disorder and that people with this disorder often do not show positive test results. In a legal case, this result will likely not be as impressive as positive results on tests that cannot be faked; however, this may be all you need to prove your problem. If this is your situation, it would be best to talk to a lawyer who has done a lot of dizziness cases to see if there is a balance test you have not yet had.
- If I experienced dizziness after my car accident, does this prove that it was caused by the car accident?
- Dizziness is a common complaint people make to their doctors and may result from a large number of disorders. It may be a symptom of a bacterial or viral infection, a symptom of a cardiovascular problem or a reaction to medication. In deciding whether your car accident caused your dizziness, doctors will look at whether you had dizziness before the collision and when you first started complaining about dizziness after the collision. If you first complained about dizziness six months after your car accident, you will likely have a problem legally.
- Do other symptoms often accompany dizziness?
- Yes. Dizziness is often accompanied by nausea, anxiety, pressure in the head and ears, ringing or buzzing in the ears and hearing loss.
- Are there any physiotherapists who have special training in treating dizziness?
- Yes. Look for one of the few British Columbia physiotherapists who has been certified at Emery University in Atlanta, Georgia as a vestibular rehabilitation expert. An alternative is to find a physiotherapist who has taken courses in B. C. from a physiotherapist who is a certified vestibular rehabilitation expert.
- Have there been any court cases and settlements where a person who suffered dizziness after a car accident was well compensated?
- Yes. Up to about 10 or 15 years ago, it was very difficult to prove that a person was disabled from working as a result of dizziness, but the scientific machine called the EquiTest and good expert testimony has now made this possible. Mr. Temple, lead injury lawyer with TNT Lawyers, was successful in the British Columbia Supreme Court for his client in the case of B. v. D. in 1995. It is still the leading case in the field of dizziness. Many cases have been settled on favourable terms since then, now that ICBC has realized that dizziness can be a very serious and legitimate injury that can be objectively and scientifically proven.
Mr. Justice Davies wrote the following in his reasons for judgement:
"The most important issue in this case is whether the plaintiff's 'nausea' or 'n. v. s. ' is causally related to either of the motor vehicle accidents. She has ongoing problems with her neck and back but the n. v. s. is the disabling condition…
Dr. Neil S. Longridge, Director of the Neuro-Otology Unit at the Vancouver General Hospital, was called in to examine Ms. B. . . Dr. Longridge has written numerous articles on dizziness. I find him to be a recognized authority in problems of imbalance and dizziness following cervical flexion extension injuries. The following is Dr. Longridge's statement of his investigation and his impression of the plaintiff following his examination of her…
'… EquiTest was undertaken. This is a test of balance function which becomes more difficult as the test goes on and this patient produced abnormalities specifically in the more difficult parts of the test which are characteristically those which indicate that she has a disorder of the balance system from the inner ear. '
'… The dizziness that she complains of is the sort I have seen not infrequently in patients who have had cervical flexion extension injuries and the abnormality on EquiTest seen with this is characteristic for that. The normal caloric response during the ENG is also typical of this condition in that the damage to the balance is not localized to the lateral semi-circular canal, which is the only part of the balance system tested by caloric test. This patient's… complaints are still going on at the present time which is approximately three years afterwards and in these circumstances it is likely they will be present on a long term basis. Unfortunately there is little that can be done to speed the process of recovery and although rehabilitation programs involving the balance system have been attempted, as yet they have not been shown to have a dramatic effect in relieving symptoms'.
The defendants had the plaintiff examined by Dr. Florian G. Braig, an Otolaryngologist…. The following is a portion of his conclusion:
'She appears to have a measurable disturbance of her vestibular function which could possibly be related to her car accidents but this will probably always remain a matter of speculation'.
The defendants obtained an opinion from Dr. Patrick J. Doyle, Emeritus Professor of Otolaryngology at the University of British Columbia. His opinion in his report… was as follows:
'… EquiTest, or computerized dynamic posturography, employs a moveable platform and a moveable background. This provides information re the three systems that are responsible for maintenance of balance, i. e. vision, vestibular function and somatosensory function. The results must be used as an adjunct to history, physical examination and other tests of vestibular function such as ENG. Ms. Brownlee performed poorly on condition 5 and condition 6. In these two instances the patient must depend on normal vestibular function in order to maintain balance. However, since she falls on each test in condition 5 and 6 this would indicate a significant loss of vestibular function, either an acute unilateral or bilateral problem or central vestibular disease. One would expect a definite history and physical finding such as positional vertigo and nystagmus and one would also expect changes on the ENG. I believe, therefore that the results on this patient's EquiTest cannot be interpreted as vestibular disease. For the many reasons mentioned above, I do not feel that this lady has symptoms related to inner ear disturbance caused by any of her motor vehicle accidents'.
Dr. Murray Allen… is a consultant in musculoskeletal disorders…. He opined that although she may suffer a form of dizziness, it is caused by a combination of drugs she is taking and further that her gastro-intestinal disorders could also contribute to her dizziness. He does not believe her neck problems cause her dizziness.
I have considered all of the medical evidence, in particular, the differing opinions with respect to the cause of Ms. Brownlee's dizziness, although I have mentioned only some of this evidence in my reasons.
I approach the question of damages on the basis of my findings with respect to her injuries. At present she suffers from pain in the centre of her back radiating to the right buttock and to the right superior anterior thigh and down to and through the knee. This pain may be brought on by new exercises without proper training. The pain worsens with prolonged sitting, lying and exercise. She also suffers pain in the left paracervical muscles of the mid-suprasucapular area. This pain radiates to the back of the head and occasionally down to the left paraspinal muscles between the scapulae. If the pain is bad it is associated with a feeling of pressure in the neck going up to the head and resulting in dizziness and weakness. It is improved with lying down and with percodan, one-quarter to one-half a tablet. It will become worse by "doing too much of anything".
Non-pecuniary damages [pain and suffering]:
There is no question that she has suffered greatly since the accident. . . The impact on her life of the combination of injuries which she received has been marked. She has not driven since the date of the accident and it is unlikely that she will drive in the foreseeable future. All her activities have been greatly curtailed. However, I would hope that if she follows the advice of Dr. Kennedy, her condition should improve to the point where she would again drive a motor vehicle.
I fix the sum of $85,000 for non-pecuniary damages. " [With inflation, this would have a value of $104,000 as of 2005].
Mr. Justice Davies also awarded Ms. B:
- $18,335 for the out-of-pocket expenses she incurred, including a great deal of assistance with her home and garden,
- $132,189 for the cost of future treatment and including physiotherapy, taxis for a period of five years, housekeeping services, gardening services, medications and a pain program costing $21,689), and
- $5,000 for investment management fees.
The Court of Appeal reduced the judge's substantial award for loss of earnings, past and future, to $300,000.
This is a total of $540,524 plus interest and costs.
Are you looking for compensation for your symptoms of dizziness after a car accident? Call us now at 604-200-5965 or email us.