$85,000 For Chronic Myofascial Pain From Three Collisions
Reasons for judgement were released today by the BC Supreme Court, Vancouver Registry, assessing damages for chronic soft tissue injuries.
In today’s case (Dhillon v. Singer) the Plaintiff was involved in three collisions which the Defendants admitted fault for or were found liable. The collisions resulted in chronic myofascial pain with a poor prognosis for further improvement. In assessing non-pecuniary damages at $85,000 Madam Justice Fleming provided the following reasons:
 Regarding the plaintiff’s physical injuries and symptoms my analysis and findings are as follows:
· After the first accident, Mrs. Dhillon experienced fairly intense pain arising from soft tissue injuries to her neck, upper back and right shoulder that interfered with her sleep, as well as headaches. Prior to returning to work, her pain symptoms had reduced significantly but they were not fully resolved. The plaintiff certainly felt well enough to work full-time. I accept that after she returned to work as a parking lot attendant, pain symptoms in her neck and her shoulder sometimes worsened causing her sleep difficulties.
· I find the plaintiff continued to experience some pain in her shoulder and neck prior to the second accident although her symptoms were not as intense or constant as she described, and were likely mild. Mrs. Dhillon testified that despite telling her doctor she was still in significant pain in January 2012, he provided her with a medical note to submit along with her application to the pharmacy assistant program confirming she was in good physical and mental health. I am not persuaded the doctor would have written such a note if the plaintiff was at that time complaining of significant ongoing pain symptoms. I also put limited weight on the gap in his clinical records from May 20, 2011 to March 2, 2012 which demonstrate the plaintiff otherwise attended appointments regularly in relation to the accidents. I consider the gap, bearing in mind the decision of Justice N. Smith in Edmondson v. Payer, 2011 BCSC 118, aff’d 2012 BCCA 114, regarding the admissibility and use of clinical records. At paras. 36 and 37 he concluded the absence of any record cannot be the sole basis for an inference about whether an injury or symptom existed or not.
· I find the second accident likely reinjured the soft tissues in the plaintiff’s neck and upper back as well as the other shoulder area, worsening and broadening her pain symptoms to some extent.
· I accept the plaintiff experienced some increased pain and discomfort while studying for prolonged periods, particularly after the second accident, given the posture required. This may have affected her ability to concentrate to some extent. Her timely, very successful completion of the pharmacy assistant program satisfies me, however, that both before and after the second accident, those symptoms were not meaningfully disabling. I do not accept her evidence that she was required to study twice as much to achieve such high grades.
· I find that by September 2012 the plaintiff’s pain symptoms were mostly mild, not modest as she testified.
· I accept the plaintiff suffered from a flare up in her pain symptoms, accompanied by fatigue and some psychological symptoms in May 2013 which lasted for at least two weeks. The date on a medical note prepared by her family doctor corroborates her evidence regarding the timing of the flare up. Employment records confirm she worked less for a two week period during that month.
· Following the third accident, I find the plaintiff experienced a significant increase in the level and scope of her pain caused by new soft tissue injuries that extended to her low back and an aggravation of previous soft tissue injuries in her shoulders, upper back and neck, along with worsened headaches. I also find that as a result of the third accident and her increased pain symptoms, previously transient psychological and cognitive symptoms including feelings of sadness or depression, irritability, anxiety, low energy and difficulties with concentration intensified markedly, particularly after she returned to work in November 2013. Although her pain symptoms had lessened considerably by then, I accept they worsened during the course of the work day, disrupting her sleep. I have no doubt the plaintiff was discouraged by the experience of working with ongoing pain and fatigue, particularly given the demands of her job as a pharmacy assistant, namely the need for accuracy. Although, I accept the plaintiff worked as much as she could, I do not accept that her pain symptoms were severe. Severe pain is inconsistent with her evidence that she worked 32 to 34 hours per week. In fact she worked more than that, except for the months in 2016 leading up to trial in August. Her employment records for 2014 indicate she rarely worked less than 35 hours per week and most often between 35 and 39 hours, not 32 to 34. I infer from the amount she actually worked that her symptoms were not as intense or as disabling as she suggested.
· I accept the plaintiff’s testimony that she attended the emergency department and received an injection in June 2014 because of increased pain, but conclude the flare up was relatively brief given her hours of work were reduced for a two-week period only. She attended the Change Pain Clinic in the fall of 2014 and declined the proposed injection series because she had less pain by then. I find her pain symptoms at that point were mostly mild and sometimes moderate. At the same time her psychological symptoms had subsided due to Pristiq allowing the plaintiff to cope more effectively.
· By 2015 or early 2016, the plaintiff’s sleep was less disrupted and she was no longer taking over the counter pain medication as frequently, indicating her pain symptoms had become intermittent although ongoing.
 After each of the three accidents, the first and third in particular, Mrs. Dhillon endured significant pain symptoms and headaches. Following the first and third accidents, her pain symptoms were severe enough to prevent her from working at all for some months. Her sleep was very disrupted. Since her return to work in November 2013, Mrs. Dhillon has continued to experience variable levels of pain in her neck, shoulders, upper and lower back and psychological and cognitive symptoms, all of which have improved and are likely intermittent, but now chronic. Ongoing pain has affected Mrs. Dhillon’s intimate relationship with her husband. She has also been somewhat less able to play badminton with her children and she avoids more elaborate cooking, something she loved to do before the accidents. Mrs. Dhillon has and will continue to experience some pain while working although not to the extent she claims. Mrs. Dhillon’s mood symptoms are reasonably well managed, although she continues to have low moments and feelings of anxiety in response to pain and fatigue. On the whole, however, the plaintiff is able to enjoy her family and everyday life and take pride in her work.
 Applying the factors identified in Stapley to the facts of this case and bearing in mind my review of the authorities provided by the parties, I conclude an award of $85,000 is fair and reasonable.