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Erik MagrakenThis Blog is authored by British Columbia ICBC injury claims lawyer Erik Magraken. Erik is a partner with the British Columbia personal injury law-firm MacIsaac & Company. He restricts his practice exclusively to plaintiff-only personal injury claims with a particular emphasis on ICBC injury claims involving orthopaedic injuries and complex soft tissue injuries. Please visit often for the latest developments in matters concerning BC personal injury claims and ICBC claims

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Archive for the ‘ICBC Thoracic Outlet Syndrome Cases’ Category

$110,000 Non Pecuniary Assessment For Chronic Pain and Major Depressive Disorder

April 3rd, 2017

Reasons for judgement were released today by the BC Supreme Court, Vancouver Registry, assessing damages for chronic injuries sustained in three separate collisions.

In today’s case (Parhar v. Clarke) the Plaintiff was injured in three collisions that the Defendants accepted blame for.  She suffered chronic physical and psychological injuries as a result including thoracic outlet syndrome, chronic pain,  major depression and anxiety.  Her prognosis for further improvement was guarded.  In assessing non-pecuniary damages at $110,000 Mr. Justice Pearlman provided the following reasons:

[215]     Ms. Parhar was 27 years old at the time of the first accident and 35 at the time of trial.

[216]     The injuries she suffered in the accidents include injuries to the muscles of her neck, shoulder girdle and back with attendant muscle spasm, low back pain, thoracic outlet syndrome, persistent headaches, TMJ pain and dysfunction and soft tissue injuries to her knees and right hip.

[217]     In addition, as a result of the defendants’ negligence, the plaintiff sustained a chronic pain disorder, a major depressive disorder, a generalized anxiety disorder and PTSD.

[218]     Although there has been some improvement in the plaintiff’s condition, Ms. Parhar’s prognosis is guarded in light of the persistence of her symptoms of pain and her psychological conditions.

[219]     Further psychological counselling would assist Ms. Parhar in coping with chronic pain and managing the functions of daily living. Exercise and conditioning will probably produce further improvements to her symptoms of neck, shoulder and back pain, and may also alleviate her headaches. However, after eight years of chronic pain, it is unlikely the plaintiff will make a full recovery and probable that she will experience flares of her back and neck pain, anxiety and depressive moods indefinitely.

[227]     Taking into account the Stapley v. Hejslet factors, all of the authorities cited by counsel, the risk that the plaintiff would have suffered a recurrence of depression in any event of the accidents, and all of Ms. Parhar’s particular circumstances, I would assess her damages for pain and suffering and loss of amenities and enjoyment of life in the amount of $110,000…


$80,000 Non-Pecuniary Assessment for Chronic Myofascial Pain and TOS

February 2nd, 2017

Reasons for judgement were released today by the BC Supreme Court, Vancouver Registry, assessing damages for chronic myofascial pain and thoracic outlet syndrome following a collision.

In today’s case (Kodelja v. Johal) the Plaintiff was involved in a 2012 collision that the Defendant accepted responsibility for.  The Plaintiff suffered chronic injuries which remained symptomatic by the time of trial and were partially limiting but not disabling.  In assessing non-pecuniary damages at $80,000 Mr. Justice Masuhara provided the following reasons:

[92]         Therefore, my summary of findings regarding the plaintiff’s injuries is: 

(a)            The Accident caused the plaintiff’s chronic myofascial pain syndrome and post traumatic thoracic outlet syndrome.  The pain is in her left neck, left shoulder and upper back.  She also has paresthesia in her left arm as a result of the thoracic outlet syndrome. 

(b)            The Accident caused the plaintiff to suffer headaches which continue.  The headache pain ranges from dull, to mild to severe.  She gets dull or mild headaches every other day and manages without medication.  She has more significant headaches once every two weeks.  They can be managed with Tylenol and Advil. 

(c)            The major areas of the pain are in her left neck, shoulder and upper back.  The right hip and groin area pain is minor and was an aggravation of a prior condition. 

(d)            The pain in her neck, shoulder and back ranges from mild to moderate. 

(e)            Her overall condition since the Accident has improved at least 50%. 

(f)              The numbness and tingling in the plaintiff’s left arm is intermittent and infrequent, the last occurrence was, at least over a year ago.  It is not disabling. 

(g)            The plaintiff has normal range of motion of the left shoulder.  Her right shoulder movements are full.  She has full flexion and extension in her cervical spine. 

(h)            The plaintiff has some physical limitations, however, she is able to carry out normal day-to-day activities including teaching, with the work support and prep time available to her, and home cleaning and cooking. 

(i)              The plaintiff is functional for basic handling, reaching, balance, stooping, lifting and carrying for amounts tested, sitting, standing and walking.  She is able to do housecleaning though has difficulty with heavier activities for which she requires some assistance. 

(j)              She is able to participate in social and recreational activities such as camping, holiday travel, and sailing, but is restricted from participation in more rigorous recreational activities such as running and swimming.  But for the demands of her work on her time, she is able to maintain a social life. 

(k)            She is able to perform her teaching duties, including leading or assisting in after school student extra-curricular activities. 

 

[102]     The ranges the parties rely on are not too far apart.  The assessment in this case, while guided by other cases, is tailored to the specifics of the present case.  My review of the cases handed up and my findings lead me to assess damages under this head at $80,000. 


$87,500 Non-Pecuniary Assessment for Neurogenic Thoracic Outlet Syndrome

July 2nd, 2015

Adding to this site’s archives addressing non-pecuniary damages for traumatically induced thoracic outlet syndrome, reasons for judgement were released today by the BC Supreme Court, Vancouver Registry, dealing with such an injury.

In today’s case (Hsu v. Choquette) the Plaintiff was involved in a 2010 collision that the Defendant accepted fault for.  The collision caused compression of nerves resulting in Thoracic Outlet Syndrome.  In assessing non-pecuniary damages at $87,500 Mr. Justice Schultes provided the following reasons:

[40]         The type of TOS that Dr. Salvian diagnosed in Ms. Hsu’s case was neurogenic (nerve-based), caused by compression of nerves in an area known as the brachial plexus.

[41]         Through a series of standard physical tests, he was able to provoke the symptoms of tingling in the right arm and all of the fingers and severe pain in the right shoulder and neck. His review of her medical and therapeutic records revealed a post-accident history of pain and tenderness in the right neck and shoulder muscles, right shoulder pain and numbness travelling down that arm to the fingers. He did not find many symptoms on the left side.

[42]         His opinion was that Ms. Hsu’s headaches and neck pain were related to injury to the muscles and ligaments of the neck and upper back. He qualified this aspect of his opinion by emphasizing that he is not a specialist in these types of injuries.

[43]         More significantly, his opinion was that her numbness, tingling and pain radiating into all of her fingers but mainly the thumb, forefinger and middle finger of the right hand was “due to a combination of post traumatic TOS and likely a component of carpal tunnel syndrome.”…

[91]         Considering the unique circumstances of this case, but keeping in mind awards made for roughly comparable injuries and levels of pain and suffering, and adding an amount for the insufficiently documented yet legitimate claim for future loss of housekeeping capacity, I will award $87,500 under this heading.


$75,000 Non-Pecuniary Assessment for Chronic but Not Disabling Thoracic Outlet Syndrome

September 8th, 2014

Reasons for judgement were released this week by the BC Supreme Court, New Westminster Registry, assessing damages for Thoracic Outlet Syndrome caused and aggravated by a series of collisions.

In today’s case (Griffith v. Larsen) the Plaintiff was involved in three rear end collisions.  The Court found the first collision caused TOS or at least TOS like symptoms and this condition was aggravated by the subsequent collision.  The Court had some concerns about the plaintiff’s credibility noting “there was an element of embellishment” with some of the Plaintiff’s evidence.  The Court accepted the Defendants were responsible for the plaintiff’s injuries but found the condition was not particularly disabling.  In assessing non-pecuniary damages at $75,000 Mr. Justice Affleck provided the following reasons:

[41]         Dr. Salvian has formed his opinions relying heavily on the plaintiff’s self-report of symptoms. This is not a criticism. Nevertheless, my conclusion is that it is appropriate to be cautious when relying on these reports. It is also my conclusion that the plaintiff, whether or not she has TOS, is gradually improving. I do not accept her symptoms are sufficiently severe or her disabilities so pronounced that she is likely to agree to surgery. Her evidence is that she would seek a second opinion from that of Dr. Salvian and in my view she will approach the question of surgery with considerable reluctance. In my view it is more likely that there will be no surgery of the type Dr. Salvian frequently undertakes with his patients.

[42]         As I have mentioned, Dr. McDonald, who knows the plaintiff’s condition, both from before and after the accidents, better than any of the other physicians who have testified, would not restrict the plaintiff’s activities in any way. I accept that evidence and it leads me to conclude the plaintiff has no present significant disabilities. Nevertheless, I find the plaintiff continues to experience symptoms, particularly from the first accident. In my view the second and third accidents were trivial but have had an exacerbating effect on the injuries from the first accident.

[43]         The “common sense” approach recommended by the defendants is that trivial collisions cause trivial injuries. That approach has superficial plausibility but no more. As Mr. Justice Thackray observed in Gordon v. Palmer, [1993] B.C.J. NO. 474 at para. 3:

Significant injuries can be caused by the most casual of slips and falls. Conversely, accidents causing extensive property damage may leave those involved unscathed. The presence and extent of injuries are to be determined on the basis of evidence given in court.

[44]         I find the plaintiff will have had about four years of painful but gradually diminishing symptoms since the first accident until she recovers. I do not find that she is feigning her symptoms but that she has overstated them. It is likely that these symptoms will subside over the coming months, particularly if the plaintiff becomes more physically active as Dr. McDonald recommends.

[45]         I also believe the plaintiff has become overly absorbed by the effects of the accidents on her life and has erroneously come to believe she is disabled from pursuing many of her former physical recreational pursuits. This belief is not shared by Dr. McDonald, nor is it my assessment of the plaintiff’s condition on all of the evidence…

[50]         I assess the plaintiff’s non-pecuniary general damages at the sum of $75,000.


$80,000 Non-Pecuniary Assessment For Mild, Chronic Thoracic Outlet Syndrome

April 15th, 2014

In the latest addition to this site’s Thoracic Outlet Syndrome caselaw database, reasons for judgement were released this week by the BC Supreme Court, New Westminster Registry, assessing damages for mild but chronic TOS.

In this week’s case (Minenko v. Minenko) the Plaintiff was injured in a 2009 intersection collision.  The at fault driver admitted responsibility.  The Plaintiff developed a mild but persistent Thoracic Outlet Syndrome which remained symptomatic at the time of trial.  In assessing non-pecuniary damages at $80,000 Mr. Justice Truscott provided the following reasons:

[27]         Dr. Shuckett saw the plaintiff on August 2, 2013 and says that the plaintiff has probably achieved maximum medical recovery and will be left with her current symptoms.

[28]         She says the plaintiff is not disabled from work although it may be more difficult for her and she should do regular walking and some regular aerobic exercises that do not over-use her upper body and arms.

[29]         Dr. Shuckett also suggests flexeril pills to decrease muscle spasm and assist the plaintiff in sleep, along with local trigger point injections and/or Botox injections into the area of muscle spasms in the right neck and shoulder girdle region could be considered.

[30]         Injection therapy, if it works, in her opinion has to be repeated every six months or so which applies to any Botox injections as well…

[38]         At trial, she says she believes she is qualified to diagnose thoracic outlet syndrome but defers to Dr. Salvian for the ultimate opinion on this as he is the primary expert on it.

[39]         At trial, she strengthens her opinion somewhat by saying she believes the plaintiff has mild thoracic outlet syndrome.

[40]         The plaintiff says she also initially suffered from anxiety attacks in the night, but only occasionally does so now. Currently, she says she has headaches and constant dull pain in her right arm, as well as the right shoulder and right upper back area. Any physical activities cause her pain in her right arm and this increases over a busy day.

[41]         She takes Advil during working hours but continues working…

[81]         There is no evidence her injuries can be alleviated through surgery but some of the pain may be ameliorated through the use of Botox…

[100]     I have reviewed all of the cases cited to me by both counsel on the issue of non-pecuniary damages and in my view, the sum of $80,000 is an appropriate amount to award the plaintiff for her pain and suffering and loss of enjoyment of life and as well for her loss of housekeeping ability.

 


$85,000 Non-Pecuniary Assessment for Chronic Thoracic Outlet Sydrome Coupled With Mild Brain Injury

July 22nd, 2013

Adding to this site’s archives addressing non-pecuniary damages for traumatically induced thoracic outlet syndrome, reasons for judgement were released last week by the BC Supreme Court, Vancouver Registry, dealing with such an injury caused in a vehicle collision.

In last week’s case (Danielson v. Johnson) the Plaintiff was involved in a 2008 collision.  Liability was admitted.  The Plaintiff, who worked installing ceilings, suffered a mild traumatic brain injury and thoracic outlet syndrome in the crash.  The Defendant took a serious run at the plaintiff’s credibility pointing out a history of cocaine use, getting paid under the table, and even lying at his examination for discovery.  Despite this the Court found the plaintiff ‘credible and reliable’.  The Court noted these injuries were caused by the collision and would likely require vocational retraining.  In assessing non-pecuniary damages at $85,000 Mr. Justice Silverman provided the following reasons:

[139]     With respect to both TOS and the MTBI, I reject the inference that prior injuries may have caused his current problems.  To the contrary, the evidence is that it is common for the long-term consequences of prior injuries to sometimes be sitting dormant, and when a newer injury emerges, a MTBI or TOS may result.  I am satisfied that has occurred here…

[146]     I am satisfied of the following: that the plaintiff did suffer a brain injury in the MVA, it was a mild brain injury, he suffers from accompanying emotional difficulties that cause additional impairment, and the consequences of the foregoing are likely to be ongoing…

[147]     The weight of the evidence supports the finding that the plaintiff does suffer from TOS as a result of the MVA and, on a balance of probabilities, I find this to be so.  I note that Dr. Fry devotes much of his medical practice to the management and treatment of TOS, both conservatively and with surgery, and that Dr. Salvian has a special interest in the diagnosis and treatment of TOS.

[148]     More than a decade ago, the plaintiff had a fracture to his neck which eventually healed completely, and he had no problems as a result of it in the five years prior to the MVA.  The research has shown that a majority of people who suffer from TOS have had a prior neck injury, perhaps even years before, which had long healed, but that set them up to be vulnerable to any further injury.  I am satisfied that this is what happened to the plaintiff.

[149]     When the plaintiff raises his right arm to the side or above his head, or in front of him (while driving) as well as into a position where his hands are at the height of his head or slightly higher, TOS symptoms are provoked. Unfortunately, he is required to do these sorts of movements at his work.

[150]     I am satisfied that the plaintiff suffers from TOS as a result of the MVA.  He has been able to function with his pre-MVA activities, including work and recreational activities, although less efficiently and less comfortably than before the MVA.  I am satisfied that the evidence indicates this will not improve; in fact, it will worsen.  Hence, the weight of the medical opinion that the plaintiff must re-train…

[167]     I agree that the plaintiff demonstrates remarkable grit in continuing to work and to be involved in extreme sporting activities, to some extent contrary to the advice he has received from various doctors and to the surprise of those doctors.  Having said that, I am satisfied that the plaintiff does so with much less ease and pleasure than he did prior to the MVA.  He has suffered a loss in that regard, and will continue to do so.

[168]     In view of all the foregoing, I award non-pecuniary damages in the amount of $85,000.


$90,000 Non-Pecuniary Assessment for Thoracic Outlet Syndrome With Poor Prognosis

April 8th, 2013

Adding to this site’s archived posts of BC non-pecuniary damage assessments for Thoracic Outlet Syndrome, reasons for judgement were released last week by the BC Supreme Court, New Westminster Registry, assessing damages for such an injury with a poor prognosis.

In last week’s case (Gillam v. Wiebe) the Plaintiff was involved in a 2009 collision.  Fault was admitted by the Defendant.  The Plaintiff sustained various injuries including a Thoracic Outlet Syndrome with a poor prognosis for full recovery. In assessing non-pecuniary damages at $90,000 Mr. Justice Verhoeven provided the following reasons:

65]         In summary, I find that the plaintiff suffered the following injuries due to the accident:  chronic right sided neck and shoulder pain, thoracic outlet syndrome, and headaches, all as described above. She has also suffered from deterioration in her mood and disposition, interference with sleep, and significant weight gain.

[66]         Her headache condition is gradually improving but she continues to suffer from frequent headaches. Her neck and shoulder pain and her TOS symptoms also continue to cause pain and limitation of function. In general, the prognosis for the plaintiff’s conditions is poor. It is likely that she will have a degree of limitation of function and pain permanently…

[85]         Some context is also provided by the video surveillance evidence. Video surveillance was conducted on 3 separate days in April and May, 2012. The video evidence shows the plaintiff carrying out ordinary activities such as pumping gas, entering and exiting her vehicle, driving, and also shopping and eating a picnic lunch with companions. She displays no obvious sign of discomfort or disability and generally looks comfortable and able to carry out such moderate activities.

[86]         Nevertheless, the plaintiff suffers from a limitation of function. She suffers from pain in her neck and shoulder which will likely never completely disappear. She is unlikely ever to be symptom free in relation to her TOS condition. She continues to suffer from frequent headaches for which the prognosis is negative for complete resolution. She is no longer capable of heavy work, and must avoid other activities that could aggravate her neck and shoulder injuries and her TOS. She is restricted in terms of employment, domestic and recreational activities. There has been a very significant change in the plaintiff’s overall lifestyle. There have been emotional consequences to her injuries. Her injuries have also made caring for her daughter much more difficult.

[87]         While of course each case is unique, other court cases provide useful guidance with respect to the proper quantum of the award. Consistency with other decisions of the courts is desirable. The award must be fair to both sides.

[88]         The plaintiff relied upon: Stapley v. Hejslet, 2006 BCCA 34 ($175,000); Hooper v. Nair, 2009 BCSC 862 ($104,500); Cimino v. Kwit, 2009 BCSC 912 ($85,000); Milliken v. Rowe, 2011 BCSC 1458 ($85,000); and Durand v. Bolt, 2007 BCSC 480 ($75,000). The plaintiff submits that the range for non-pecuniary damages in this case is $95,000 to $135,000. The defence also relies upon Cimino, and Durand. Additionally, the defence cites Driscoll v. Desharnais, 2009 BCSC 306 ($55,000)Langley v. Heppner, 2011 BCSC 179 ($55,000), and Verhnjak v. Papa, 2005 BCSC 1129 ($40,000). The defence submits thatDriscoll and Langley most closely equate to this case, and submits that an appropriate award is $60,000.

[89]         Having reviewed these authorities, in my view an appropriate award for non-pecuniary loss in this case is $90,000.


$75,000 Non-Pecuniary Assessment For Thoracic Outlet Syndrome with Poor Prognosis

February 8th, 2013

Adding to this site’s archives of BC Supreme Court damage assessments for Thoracic Outlet Syndrome, reasons for judgement were released last month addressing such an injury.

In last month’s case (Jawanda v. Samra) the Plaintiff was injured in a 2006 collision.  She was 29 years old at the time and 35 by the of her trial.  She suffered from Thoracic Outlet Syndrome as a result of the collision with accompanying chronic pain.  The Plaintiff, although able to hold down employment despite her injury, remained symptomatic and the injuries were expected to be permanent.  The Court accepted the following medical evidence addressing prognosis:

 With respect to her thoracic outlet syndrome, it is now a permanent injury to the scalene muscles in an already compromised thoracic outlet due to her congenital cervical ribs. It is my opinion that Ms. Jawanda’s symptoms are unlikely to change or improve but it is my opinion that the symptoms of numbness and tingling and paresthesias would get worse if she was forced to overdo it or continue to do heavy activities which exacerbated her symptoms. This would lead to more chronic muscle and nerve injury and more prolonged pain.

In assessing non-pecuniary danages at $75,000 Mr. Justice MacKenzie provided the following reasons:

[143]     Balancing all of the evidence I have accepted, I find Ms. Jawanda suffers from mild to moderate chronic pain and thoracic outlet syndrome. Coupled with the authorities referred to by counsel, I am satisfied a fair and appropriate award for non-pecuniary damages is $75,000.


Why Labels Don't Matter – More on BC Injury Claims and Non-Pecuniary Damage Assessments

January 9th, 2013

When assessing damages for injuries the BC Supreme Court will not address the injuries as ‘items on a grocery list’.   The exact label attached to an injury is far less important than the ways in which an injury compromises a Plaintiff’s life.  This was highlighted in a recent judgement from the BC Supreme Court, Kamloops Registry.

In the recent decision (McKay v. Powell) the Plaintiff was involved in three rear-end collisions.  As a result she suffered from a chronic pain disorder.  As is often the case, in the course of her lawsuit the Plaintiff was assessed by a variety of physicians who had competing diagnoses for the Plaintiff’s symptoms, namely fibromyalgia vs thoracic outlet syndrome.  Demonstrating that whatever the correct diagnosis, the symptoms were caused by the collision and the plaintiff was entitled to appropriate compensation, Mr. Justice Meiklem provided the following reasons:

[44]         Clearly the cumulative effects of the three accidents in this case have placed Ms. McKay in a position where she has chronic pain disorder as stated by Dr. Mosewich, regardless of the lack of consensus as to whether there is possibly a thoracic outlet syndrome or fibromyalgia in play. No expert has ventured a specific prognosis as to complete resolution of her symptoms. Dr. Wade holds out a hope that further rehabilitation with exercises will reduce her symptoms while participating in daily activities, recreation and occupation. Dr. Mosewich recommended regular exercise and physiotherapy, but recognized a continuing need for pain modulating medication. If Dr. Apel’s diagnosis of fibromyalgia is correct, the plaintiff’s condition will wax and wane, but there will be no full recovery…

[50]         Considering the cited cases, the individual circumstances in the present case, and the factors relevant to assessing this head of damages as set out in Stapley v. Hejslet, 2006 BCCA 34, I assess non-pecuniary damages in the amount of $65,000.


$80,000 Non-Pecuniary Assessment for Aggravation of Pre-Existing Thoracic Outlet Syndrome

November 1st, 2012

Adding this this site’s archived cases addressing non-pecuniary damages for thoracic outlet syndrome, reasons for judgement were released last month addressing such an injury.

In last month’s case (Rollheiser v. Rollheiser) the Plaintiff was injured in a 2008 collision.  She suffered from long-standing Thoracic Outlet Syndrome.  The crash caused an aggravation of this condition with the Court accepting the following medical evidence:

[24]         Dr. Flaschner, a specialist in physical medicine and rehabilitation, also provided a report, dated February 2, 2012. Dr. Flaschner initially saw Ms. Rollheiser on December 2, 2009. His diagnosis included exacerbation of pre-existing TOS and musculoligamentous injuries to the cervical and thoracic spine. He states:

Ms. Rollheiser has subsequently been seen on numerous occasions for symptomatic management. She has undergone various trials of medications, local anesthetic trigger point injections botulinum toxin injections and has also been receiving regular IMS therapy from her physical therapist. Her pain has evolved as well and the current diagnoses secondary to the motor vehicle collision would include:

1.   Thoracic outlet syndrome, exacerbation of pre-existing injury.

2.   Cervical WAD II injury with chronic regional myofascial pain syndrome.

3.   Thoracic musculoligamentous injury with chronic regional myofascial pain syndrome.

[25]         Dr. Flaschner considers that Ms. Rollheiser’s symptoms will continue indefinitely.

[26]         Dr. Flaschner’s report continues:

Further symptomatic management options for the chronic regional myofascial pain syndrome would include regular physical activity from a cardiovascular perspective as well as stretching and strengthening of the painful musculature, ensuring adequate restorative sleep, various manual therapies, medications as well as needle based therapies including acupuncture, IMS, local anesthetic  trigger point injections, botulinum toxin injections or potentially fluoroscopically guided facet based procedures. It should be noted that the treatments will be expected to provide some temporary relief and would not be expected to be curative.

In assessing non-pecuniary damages at $80,000 Madam Justice Gropper provided the following reasons:

[35]         In sum, Ms. Rollheiser’s injuries have reduced her enjoyment of life. There has been impairment of family, marital and social relationships as well as physical abilities.

[36]         As noted, the case authorities provide guidance only; no two cases are exactly alike.

[37]         I agree with the defendant that not all of Ms. Rollheiser’s symptoms are attributable to the accident. It appears that some of the plaintiff’s limitations are due to the rotator cuff as opposed to injuries from the accident.

[38]         Of the authorities provided, I find Kaleta v. MacDougall, 2011 BCSC 1259 (Kaleta) to be most instructive. Justice Truscott awarded a 28 year-old male plaintiff non-pecuniary damages of $80,000 for soft tissue injuries to the knee, back, arm, shoulder and neck. Like Ms. Rollheiser, Mr. Kaleta only missed a brief period from work, although he found it to be more difficult to resume work upon his return. Again, like Ms. Rollheiser, his moderate ongoing pain was probably chronic.

[39]         Accordingly, I assess Ms. Rollheiser’s non-pecuniary damages at $80,000.