Adding to this site’s archived case summaries addressing soft tissue injury damages, reasons for judgement were released this week by the BC Supreme Court, Vernon Registry, assessing damages for a lingering whiplash injury.
In this week’s case (Kelly v. Kotz) the Plaintiff was involved in a 2009 collision. The Defendant admitted fault. The Plaintiff suffered a whiplash type injury which caused chronic headaches. Although there was improvement with time some symptoms still lingered at the time of trial. In assessing non-pecuniary damages at $45,000 Madam Justice Hyslop provided the following reasons: [100] I do find that in the accident the plaintiff suffered neck and upper back injuries, and that headaches are a symptom of those injuries… [105] She stated that six months after the accident there were days that she felt normal, though there were times that the headaches got worse as to severity and duration and affected her level of concentration. These descriptions are consistent with her reporting to Sarah Robson and Carey Jones. [106] When Dr. Brownlee saw the plaintiff, she had normal range of motion and some pain with flexion, particularly with the extension of her neck. The plaintiff told Dr. Brownlee that her symptoms gradually improved, but never resolved themselves completely… [122] I conclude that the plaintiff’s symptoms have improved as she described to Dr. Brownlee and will continue to improve. [123] In assessing non-pecuniary damages, I considered the plaintiff’s special circumstances and the case law cited to me by both plaintiff and defendants. [124] I award $45,000.00 for non-pecuniary damages.
Adding to this site’s case-law archives dealing with ICBC soft tissue injury cases, reasons for judgement were released this week by the BC Supreme Court, Nanaimo Registry, assessing damages for a moderate soft tissue injury.
In this week’s case (Aubin v. Ball) the Plaintiff was injured in a 2009 collision. Fault was admitted by the Defendant. The Plaintiff suffered a moderate soft tissue injury that was “substantially recovered” by the time of trial. She continue to have some symptoms, however, and these were expected to be “here to stay“. Despite finding that the Plaintiff “is likely exaggerating her present difficulties to some degree” the court concluded the Plaintiff had genuine ongoing symptoms. In assessing non-pecuniary damages at $75,000 Mr. Justice Baird provided the following reasons: [105] I think it is clear, on all of the evidence, that the plaintiff suffered moderate soft tissue injuries in the September 2009 accident and that these negatively affected her life in a variety of ways for quite some time. [106] There is also little doubt that her injuries have substantially resolved, to the extent that her present difficulties may be succinctly stated to be a Grade II whiplash associated disorder to her cervical spine and upper back (right side), and a lumbosacral sprain injury involving the lower lumbar spine and right sacroiliac region, with muscular pain in her right buttock and right hip region. [107] In most important ways, I was impressed by the plaintiff as a witness. She struck me as an intelligent and articulate person who, for the most part, had followed the directions of her caregivers and medical advisers and made creditable efforts to get over her injuries and return to her former lifestyle… [117] With some reluctance I find that Ms. Aubin is likely exaggerating her present difficulties to some degree. On the basis of everything I have heard from her and others, I conclude that she is doing so unconsciously without any active intention to mislead. [118] However I have no reason to reject the proposition, seemingly concurred in by all the witnesses, expert or otherwise, that Ms. Aubin continues to suffer from back pain related to the accident, and that this condition, in the words of Dr. Njalsson may be “here to stay”… [129] In recognition of the fact that Ms. Aubin was not as active in approaching recovery as she could have been, but without penalizing her for not being as robust as some plaintiffs, a just, fair and reasonable award in this case is $75,000. The defendant must take his victim as he finds her, and in this case, the accident caused a young woman who was on track in pursuing her ambitions and goals to go off course and lose some very good years of her life. This is no trivial matter.
It seems there has been a lot of judicial scrutiny as of late of expert witnesses crossing the line into client advocacy. Reasons for judgement were released last week by the BC Supreme Court, Victoria Registry, providing the latest example of this.
In last week’s case (Thibeault v. MacGregor) the Plaintiff was injured in a 2010 collision. It was a so-called ‘low velocity impact’ but the Court rejected this defence and found the Plaintiff did sustain a moderate whiplash injury. Non-pecuniary damage were assessed at $35,000. In the course of the lawsuit the Defendant arranged for an independent medical exam of the Plaintiff. This physician provided opinion evidence which the Court largely rejected. In doing so Mr. Justice Weatherill provided the following criticism: [95] Counsel provided detailed written submissions on the issue of the Vondette Report’s admissibility. I agree generally with the submissions of plaintiff’s counsel. Dr. Vondette’s report is prolix in the extreme. Dr. Vondette’s review of the plaintiff’s background was beyond thorough and comprehensive – it reported the minutia of the plaintiff’s social, family, psychological and medical history. He opines on matters that have no relevance to the plaintiff’s claim in this proceeding: He overreaches into the areas reserved for the trier of fact. He makes remarks that go solely to the plaintiff’s credibility. His report in many places is argument in the guise of opinion. Much of the report purports to be opinion when what is written is not an opinion at all but rather a regurgitation of the plaintiff’s complaints. .. 97] After hearing counsel’s submissions, I concluded that Dr. Vondette was probably an expert whose opinions, properly articulated, could be of benefit to the Court. Although I found the vast majority of the Vondette Report to be inadmissible, I decided that it was in the interest of justice to grant leave allowing Dr. Vondette, with counsel’s assistance, to produce a summary of those portions of the Vondette Report that are properly admissible. [98] Dr. Vondette did so. His summary (“Summary”) is two pages in length and captures succinctly and helpfully the opinions he was attempting to express in his report. The Summary, together with counsel’s letter of instruction and appendices “A” and “E” from the Vondette Report were collectively marked as Exhibit 7. [99] Unfortunately, Dr. Vondette’s oral testimony was not as helpful as was the Summary. He returned to the prolix method of communicating that he suffered from when writing his report. He sought to justify this communication method on the basis that “I am a competent and thorough physician” and that any review of the plaintiff’s circumstances that was less than comprehensive and itemized is “rubbish”. [100] Dr. Vondette pontificated throughout his testimony regarding the virtues of his specialty and his experience within it. In addition to the field of physiatry, he apparently views himself as having bountiful knowledge in other specialties in which he has no formal training, including psychiatry, psychology gynecology, physiotherapy, family medicine, social work and occupational therapy. He testified that his expertise is such that he tells physiotherapists “exactly what I want done”… [103] Dr. Vondette was argumentative and condescending throughout his cross-examination. Virtually all of his answers were lengthy monologues. He was critical of Dr. MacKean’s March 5, 2012 report because it was only two pages in length. He was critical of her December 5, 2012 report because, in forming her opinion, she reviewed and relied upon only her March 5, 2012 report and Dr. Salmaniw’s two July 2012 reports. [104] Dr. Vondette refused to agree that Dr. Salmaniw, as the plaintiff’s family doctor for more than 20 years, knew more about the plaintiff and what was best medically for her than he did after a three hour consultation. In Dr. Vondette’s words: “I think I can reasonably size up what’s going on here”. [105] Finally, Dr. Vondette described Mr. Harvie’s physiotherapy methods as “strange off-shore theories followed by a bunch of over-excited disciples”. In his view, the plaintiff needed to be taken out of the hands of Mr. Harvie and sent to a physiotherapist who is more orthodox and who performs scientifically validated forms of treatment. [106] Needless to say, the approach to the role of an expert witness in the context of court proceedings that Dr. Vondette followed is unhelpful, counterproductive and is to be discouraged. It is not within the purview of an expert witness to determine facts or issues of credibility and reliability: Brough v. Richmond, 2003 BCSC 512 at paras. 14 – 17. Unfortunately, Dr. Vondette allowed his subjective views of the plaintiff formed from his review of her medical and personal history to overwhelm whatever impartiality he may initially have had. I have been unable to take meaningful guidance from his opinions and testimony. To the extent that his opinions conflict with those of Drs. Salmaniw, MacKean and Reeves, I accept the opinions of the latter experts and reject those of Dr. Vondette.
Adding to this site’s archived soft tissue injury caselaw assessments, reasons for judgement were released recently by the BC Supreme Court, Vancouver Registry, assessing damages for a chronic soft tissue injury with an ultimately good prognosis.
In the recent case (Chingcuangco v. Herback) the Plaintiff was involved in a 2008 collision for which she was not at fault. She suffered soft tissue injuries to her neck and back which continued to pose problems at the time of trial. Despite their long duration the prognosis for full symptom recovery was good with the Court finding they would resolve within a further 5 years. In assessing non-pecuniary damages at $45,000 Mr. Justice Weatherill provided the following reasons: [197] The plaintiff felt some immediate pain in her chest and right toe after the accident. She had no loss of consciousness. X-rays taken at the hospital shortly after the accident were negative. As the days and weeks progressed, she developed debilitating pain in her neck and lower back, with resulting headaches. She had bruising on her chest and abdomen. She was unable to go to work at CRA for two weeks. [198] The bruises and the pain she suffered in her chest and right toe pain resolved completely within six weeks. Although she thought her lower back pain had resolved by the end of 2009, she has since experienced severe flare-ups several times since then. [199] The plaintiff has tried various modalities of treatment. They have provided temporary but not permanent relief. The plaintiff continues to experience persistent pain and muscle spasms. She will continue to have episodic flare-ups of pain in her lower back and cervical spine with associated headaches. I am satisfied that such episodes have been and will continue to be the result of the injuries she suffered during the September 15, 2008 accident… [201] I find that the plaintiff suffered a Grade II whiplash injury as a result of the September 15, 2008 accident. She also suffered contusion injuries to her chest and lower abdomen, chest wall strain and a chipped tooth. Over four years have passed since the accident and she still suffers from intermittent neck and lower back pain and tension headaches as a result of the accident. [202] I find that it is reasonable to expect the plaintiff will be fully recovered within five years. In part, I make this finding on the basis that the plaintiff is an achiever. Dr. Mergens gave evidence that she might still suffer some muscle tension headaches for an indefinite period. He did say these symptoms may dissipate with time and conditioning. However, there is no reasonable prospect of permanent impact upon her capabilities. [203] After considering all of the evidence, the submissions of counsel and the case authorities, I find that an appropriate award for non-pecuniary damages in this case is $45,000.
In my continued effort to highlight judicial scrutiny of expert witnesses, reason for judgement were released last week by the BC Supreme Court, Kamloops Registry, rejecting an expert psychiatric opinion.
In last week’s case (Moritz v. Schmitz) the Plaintiff was injured in a 2007 collision. She was 17 years old at the tine and “was a healthy teenager“. The collision caused chronic soft tissue injuries along with a worsening of pre-existing psychological difficulties. The Court awarded $80,000 for the Plaintiff’s non-pecuniary damages.
In the course of trial the Defendant called a psychiatrist who provided an opinion that the collision was not the cause of the Plaintiff’s aggravated pscyhological difficulties. In rejecting this opinion Madam Justice Gropper provided the following critical comments: [70] Dr. Solomons goes on to suggest that, in his opinion, it is “most likely that the course of her psychiatric difficulties after the accident was related to stressors unrelated to the accident”, referring to matters that occurred prior to the motor vehicle accident. He then concludes that the plaintiff would have experienced the same symptoms even if the accident had not occurred. Again, Dr. Solomons does not provide a foundation for his opinion that the problems Ms. Mortiz faced before the accident are of greater significance than those she faced because of the accident. He was aware that the plaintiff suffered from physical injuries but he does not turn his mind to whether those injuries may have affected her psychiatric functioning. [71] Dr. Solomons does not explain his emphasis on pre-accident events. This same observation in respect of Dr. Solomon’s emphasis on pre-accident events was made by Mr. Justice Willcock in Jokhadar v. Dehkhodaei, 2010 BCSC 1643 at para 135: Further, there is no reason, in my view, to regard stressors other than the car accident as more compelling or predominant. Dr. Solomons, in reaching that conclusion, ignored clear evidence of the significance of the accident. [72] I also note that Dr. Solomons’ final paragraph under the “Opinion” section of his report is based on “facts” that are wrong. He says Ms. Moritz was “psychiatrically disabled before the accident and was not working at the time of the accident.” He fails to note that she was 17 years old and in grade 12 at the time of the accident. She was not psychiatrically disabled from working. He says that “[s]he had no psychiatric requirement for time off work as a result of the accident since she was already on long term psychiatric disability … .” Again, she was not off work because of her psychiatric disability before the accident; nor was she on long-term psychiatric disability. In all of the circumstances, I am unable to accept Dr. Solomons’ opinion.
Reasons for judgement were released this week by the BC Supreme Court, Vancouver Registry, assessing damages for a long term soft tissue injury.
In the recent case (Sahota v. Ho) the Plaintiff was injured in a 2001 collision. He was 9 years old at the time. He suffered soft tissue injuries which continued to be symptomatic. Although the Court rejected the Plaintiff’s characterization as to the severity of his symptoms the Court accepted they were on-going and would continue indefinitely In assessing non-pecuniary damages at $40,000 Mr. Justice Cohen made the following findings: [185] Thus, I find as follows: (1) the plaintiff sustained injuries to his head, abdomen and neck as a result of the accident on September 29, 2001. The plaintiff’s injury to his head and abdomen resolved shortly after the accident. The plaintiff continued to experience occasional headaches, but this symptom has also since resolved. The plaintiff’s neck pain is on-going and will likely continue indefinitely; (2) the plaintiff’s injury to his neck was a mild, soft tissue injury. The evidence from the clinical records of Dr. Chua is that from both a subjective and objective point of view, he noted “mild” with respect to what the plaintiff reported to him and what he found upon examination. He also conceded in cross-examination that he did not ever use the terms “moderate” or “severe” in his clinical records. In my opinion, the plaintiff’s complaints regarding his neck pain were not as severe as described by the plaintiff and his father in their testimony. I do not agree with the plaintiff’s position that the plaintiff’s neck is appropriately characterized as a “moderately severe cervical strain” as stated by Dr. Chua in his August 2007 report; and (3) the neck pain experienced by the plaintiff was intermittent, rather than every day or “constant” as the plaintiff and his father insisted. If the plaintiff or his father had reported to Dr. Chua that the plaintiff experienced neck pain every day, or that the plaintiff’s neck pain was “constant”, then Dr. Chua would have written this description in his clinical records. Instead, Dr. Chua recorded that the pain was “on and off” or “recurrent”, terms which are not synonymous with the word “constant”. Furthermore, those terms were used elsewhere in Dr. Chua’s clinical records in reference to other symptoms that do not support such an interpretation. I also prefer the testimony of Ms. Porter to that of the plaintiff’s father regarding whether the plaintiff experienced improvements in his condition over the period of time following the accident. Her testimony is in keeping with the evidence of Dr. Chua who mentioned in his report of August 2002 that the plaintiff had improved from his injuries… [202] I am mindful that the plaintiff continues to be symptomatic and that his neck pain is likely to continue in the foreseeable future. However, given my findings on the chronicity and severity of the plaintiff’s pain, in the context of the evidence regarding the extent of the suffering and inconvenience experienced by the plaintiff following the accident, I find that a fair award to him for general damages is $40,000.
While the BC Supreme Court Rules generally deprive a Plaintiff of costs who bring an action to trial that could have been brought in small claims court the BC Court of Appeal clarified that having ‘sufficient reason’ to sue in the BC Supreme Court is not limited to quantum of damages alone. Reasons for judgement were released this week by the BC Supreme Court, Vancouver Registry, considering some such other factors.
In this week’s case (Bae v. Vasquez) the Plaintiff was injured in a 2010 rear-end collision. The Plaintiff suffered relatively minor soft tissue injuries. She sued in the BC Supreme Court and was awarded damages of just over $12,000. ICBC argued she should not be awarded costs as the action could have been brought in small claims court. Madam Justice Baker disagreed finding that ICBC’s initial denial of liability, LVI Defence and the Plaintiff’s language barriers were all reasons justifying bringing the action in the Supreme Court. In awarding costs the Court provided the following reasons: [69] I am satisfied that this case had neither legal nor factual complexities that made the Supreme Court a necessary venue. I have already referred to the fact that a jury trial was not an option in any case; and there will be no need to enforce the judgment outside of the province. [70] In some cases, the fact that the plaintiff had difficulty with the English language; and therefore would have difficulty pursuing the claim without the assistance of counsel, has been held to be sufficient reason to proceed in Supreme Court, where the possibility of recovering costs makes it easier for a plaintiff to find counsel willing to act. [71] Plaintiff’s counsel submits also that in this case, the defendant denied liability for the accident in the Response to Civil Claim. Plaintiff’s counsel has advised the Court that prior to the action being commenced, the defendant’s insurer had indicated: …that due to the “minimal nature of the impact forces involved in the collision”…the Plaintiff had not sustained any “compensable injury”. [72] The defendant did not admit liability until January 30, 2012 and even at that date, continued to maintain that the plaintiff had suffered no injury, loss, damage or expense as a result of the accident. [73] Plaintiff’s counsel submits that because the defendant was maintaining that the plaintiff’s negligence was the sole cause of the accident, an examination for discovery of the defendant was necessary and that procedure would not have been available to the plaintiff in Provincial Court. Counsel pointed out that at the plaintiff’s examination for discovery in July 2011, she was asked questions pertaining to liability, including whether she had consumed alcohol or drugs prior to the accident; whether she was familiar with the location where the accident happened; whether her vehicle had been properly maintained and was in proper working order and whether she had a valid driver’s licence at the time. [74] It was not until August 18, 2011 – after both the plaintiff and defendant had been examined for discovery – that defendant’s counsel wrote to plaintiff’s counsel suggesting that the action should be heard in Provincial Court and seeking the plaintiff’s consent to transfer the action to that court. Plaintiff’s counsel replied on September 21, 2011 indicating that if the trial could be heard in Provincial Court in the same time frame as the trial date set in Supreme Court – March 2012 – then the plaintiff would consider the request for a transfer. Defendant’s counsel was asked to make inquiries to determine when the trial could be heard if transferred to Provincial Court. No reply was received. [75] Ms. Bae testified at trial with the assistance of an interpreter. She had been examined for discovery without an interpreter and at trial indicated she had misunderstood some of the questions asked of her. Ms. Bae is not an assertive individual and I am satisfied she would have had considerable difficulty pursuing this action without the assistance of counsel. Of course, parties may be and often are represented by counsel in Provincial Court, but the unavailability of costs makes it more difficult to find representation. There was a denial of liability in circumstances where normally liability would be admitted and it was reasonable for the plaintiff to wish to examine the defendant for discovery on the issue of liability – a procedure unavailable in Provincial Court. [76] Taking all of these factors into account, I am of the view that there was sufficient reason for the plaintiff to bring her action in Supreme Court. I award the plaintiff costs, the costs to be governed by Rule 15-1(15).
Adding to this site’s archived posts addressing Low Velocity Impacts, reasons for judgement were released last week by the BC Supreme Court, New Westminster Registry, rejecting this defence.
In last week’s case (Christoffersen v. Howarth) the Plaintiff was involved in a 2010 rear end collision. Fault was admitted by the Defendant. The Plaintiff suffered a soft tissue injury which was still symptomatic at the time of trial but there was an “excellent prognosis” for full recovery. The Court assessed non-pecuniary damages at $35,000 but prior to doing so Mr. Justice Weatherill provided the following comments criticizing the LVI Defence: [54] The defendant urges me to draw what she described as the common sense inference that the plaintiff could not have been injured in such a minor collision. Simply put, the defendant argues that the minimal damage speaks for itself and that no other evidence is necessary to show the plaintiff did not sustain any injury… [58] In order to accept the defendant’s argument, I would have to completely disregard the evidence of both the plaintiff and Dr. Morgan that the plaintiff was injured as a result of the collision. I am not prepared to do so. I found each to be credible, honest and forthright. Their evidence was uncontroverted by the defendant. At most, the plaintiff’s evidence was shown on cross examination to have been exaggerated in a few minor respects. [59] The defendant chose not to lead any medical evidence or opinion to contradict that of Dr. Morgan. No evidence was led by the defendant regarding the amount of force that the plaintiff’s body was subjected to during the collision or how the shock absorbers built into the vehicles’ bumpers affected the damage that otherwise would have been sustained. In my view, such evidence was required if the defendant wished to argue that the plaintiff was not injured by this collision. [60] I accept that the collision was relatively minor. However, even a low impact collision can cause injury: Lubick v. Mei, 2008 BCSC 555 at paras. 5-6. Here, the evidence clearly establishes that this low velocity impact was sufficient to move the plaintiff’s vehicle forward from a completely stopped position even though the plaintiff had her foot on the brake pedal. [61] Causation has been established by the plaintiff.
Adding to this site’s BC soft tissue injury caselaw database, reasons for judgement were released recently by the BC Supreme Court, Kamloops Registry, assessing damages for a lingering Grade II soft tissue injury.
In the recent case (Nokleby v. Fiddick) the Plaintiff was involved in a 2007 rear-end collision. Fault was admitted by the rear motorist. The Plaintiff suffered from soft tissue injuries to his neck and shoulder and these continued to be symptomatic at the time of trial and were expected to linger into the future. The Plaintiff also advanced allegations that the collision caused fibromyalgia and PTSD although this evidence was not accepted. In assessing non-pecuniary damages for the lingering soft tissue injuries at $40,000 Madam Justice Hyslop provided the following reasons: [83] I find that the plaintiff, as a result of the accident, injured his neck which caused headaches and injured his left shoulder. I find that as a result of the shoulder injury the plaintiff can continue with his employment activities and all his activities and responsibilities both at home and on the farm. I find that in performing some of his farm activities he may experience some discomfort… [85] I find also the plaintiff’s shoulder injury interferes with him being able to split wood to heat his house. The plaintiff claims that as a result of his injuries, in particular his shoulder causes him to fall more. However, Dr. Laidlow found no medical explanation for this… [90] I award the plaintiff $40,000.00 in non-pecuniary damages. In doing so, I take into consideration the difficulties the plaintiff suffered in pursuing his farming activities.
As discussed on numerous occasions, a Plaintiff who fails to take reasonable steps to aid in their own recovery can have their damages reduced for a ‘failure to mitigate’. In considering weather a Plaintiff’s failure to seek treatment is reasonable their personal circumstances are taken into account. It is well established that lack of funding can reasonably excuse a course of otherwise helpful therapy. Reasons for judgement were released this week by the BC Supreme Court, Vancouver Registry, further demonstrating this principle.
In this week’s case (Rozendaal v. Landingin) the Plaintiff was injured in two collisions. She was faultless for both. She suffered soft tissue injuries to her neck, shoulders and upper back which continued to the time of trial and were expected to carry on in the future. Non-Pecuniary damages of $40,000 were awarded.
The Defendant argued that the Plaintiff’s damages should be reduced due to her failure to carry on with physiotherapy. Madam Justice Holmes found that greater therapy indeed would have made a difference but given the Plaintiff’s circumstances her failure to attend was not unreasonable. In dismissing the defendant’s arguments the Court provided the following reasons: [66] On the medical evidence, I find that Ms. Rozendaal likely could have improved to a greater extent and more quickly had she undertaken a focussed course of strengthening and conditioning therapy or training designed for her particular injuries, such as Dr. O’Connor outlined in his second report. The various forms of massage Ms. Rozendaal undertook gave her relief from her pain, but, as Dr. O’Connor explained, passive therapies did not help rehabilitate the muscles which, ultimately, were causing that pain. [67] The question is whether Ms. Rozendaal acted unreasonably by failing to undertake the recommended therapies or programs. I find that in her particular personal circumstances, she did not. .. [70] As I find, Ms. Rozendaal’s life circumstances left her unable to fund any form of ongoing treatment or therapy. From their early days together, she and Mr. Landingin have worked extremely hard to educate themselves for careers and to provide financial support and loving care for their young family. It is clear from the evidence that life was not easy for them. I have no difficulty accepting that other financial priorities displaced ongoing physiotherapy or active rehabilitation for Ms. Rozendaal, particularly since it seemed to her that massages from Mr. Landingin and exercises she did at home were just as helpful. [71] As I find, Ms. Rozendaal was mistaken in this assessment. However, it was only when Dr. O’Connor saw Ms. Rozendaal before preparing his second report (of January 18, 2012), and asked her to demonstrate the exercises she had been doing since he had seen her six months earlier, that he realized that he had not given his instructions specifically enough: Ms. Rozendaal was doing light aerobic work and some gentle neck exercises, but no real strengthening. Dr. O’Connor testified that because Ms. Rozendaal had evidently misunderstood his recommendation in the previous report, he described the recommended conditioning more explicitly in the second report. [72] The law does not require perfection in the pursuit of rehabilitation. It requires instead that a plaintiff make efforts which are reasonable and sincere in the plaintiff’s own personal circumstances: Gilbert at para. 203. [73] On this basis, in Tsalamandris v. MacDonald, 2011 BCSC 1138 at paras. 227-30, varied on other grounds 2012 BCCA 239, the Court found no failure to mitigate where the plaintiff was unable to pursue the recommended treatments because of life circumstances that included a pregnancy, the care of small children at home, and her inability to perform the recommended exercises properly without the help of a personal trainer. [74] I find similarly that Ms. Rozendaal’s efforts at rehabilitation were reasonable and sincere in her own personal circumstances.