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Causation

I feel like my crash injuries have affected every area of my life in a negative way. While I admit to being overwhelmed at times before the crash, I feel like it has been so much worse since. How will the court separate my already messy life from the bigger mess it has become?

In the recent case of Siddall v. Bencerif (2016 BCSC 1662) the plaintiff was involved in two collisions from which she claimed to suffer from chronic pain in her shoulders and neck with accompanying headaches. The plaintiff also claimed significant increase in her pre collision anxiety and psychological issues. She claimed that although she suffered periods of major anxiety and depression for most of her life, those periods were a direct result of specific traumas and the post collision issues were a direct result of her collisions. She claimed the physical and psychological injuries caused significant impacts to her personal relationships, employment, and educational pursuits.

Due to the significant pre-crash history of psychological issues, causation was a significant issue. Credibility was the determining factor. Mr. Justice Weatherill noted that:

[182]     As is the case in most personal injury actions, the most important witness in the determination of causation is the plaintiff herself.  Once an assessment of the credibility and reliability of the plaintiff’s evidence has been made, the court is generally in a position to determine causation, usually with the assistance of opinion evidence from qualified medical experts.

[183]     A plaintiff who accurately describes his or her symptoms and circumstances before and after the collision without minimizing or embellishing them can reasonably anticipate that the court will find his or her evidence to have been credible and reliable. 

Unfortunately for the plaintiff, Justice Weatherill did not find the plaintiff to be credible in her testimony.  This affected his ability to rely on  the opinion evidence of the medical experts:

[189]     The plaintiff’s antics and demeanour during cross-examination, as well as her numerous and vehement attempts to convince the court of her ordeal, evoked the oft-quoted line from Hamlet: “the lady doth protest too much”.

[191]     As a consequence, I have not found the opinion evidence of the medical experts of much assistance.  That is not because the experts are lacking in the necessary experience and expertise in their respective fields.  Indeed, they are all highly qualified.  Rather, it is because medical experts necessarily take a patient’s complaints at face value and then offer an opinion based on those complaints.  Here too they relied for their respective opinions to a significant degree on what they were told by the plaintiff without the benefit, as the court had, of a thorough and lengthy cross-examination of the plaintiff during which her self-reports and evidence generally were tested.

When ruling on causation, while Mr. Justice Weatherill did find the plaintiff to be the quintessential “thin skull” plaintiff, he did not accept the testimony that she was “thriving” prior to the first collision.

[198]     My assessment of the plaintiff is that, although very intelligent, ambitious and career driven, she neither is nor has ever been a stoic individual.  She is and was an anxious and vulnerable woman.  Because of her traumatic upbringing, she is and since her early teenage years has been mentally and emotionally fragile.  Moreover, chronic neck and shoulder pain and headaches were her “original position” before the Collisions.  In that regard, she is the quint essential “thin skull” plaintiff.  I accept that, as a result, added stress in her life will increase her anxiety level.  However, I do not accept the submissions of plaintiff’s counsel that the plaintiff was “thriving” prior to the First Collision.  Rather, to the extent that the plaintiff’s symptoms were reduced prior to the First Collision, it was because she had not been in school between April and September 2011 and, thus, had not been subjected to the physical demands of writing papers and the emotional demands of deadlines.

[204]     On the whole of the evidence before me, I find that at the time of the First Collison, the plaintiff was likely suffering anxiety and other pressures from the first semester of her Master’s degree, which was her pattern during her undergraduate degree at ECU.  I accept Dr. Lu’s opinions in this regard.  The plaintiff was managing her long-standing, chronic headaches as well as shoulder, neck and back pain with treatments of physiotherapy, massage therapy and acupuncture.

[205]     I find that the First Collision exacerbated the plaintiff’s pre-existing physical symptoms of headaches as well as pain in her neck, shoulders and lower back.  I also find that the First Collision caused the plaintiff episodes of renewed anxiety, including some panic attacks.  The November 19, 2011 collision into the path of an oncoming car on a residential street also served to increase her anxiety.

[206]     I find that the plaintiff’s physical symptoms caused by the First Collision resolved within several months, however, her moderately increased symptoms of anxiety continued until the Spring of 2012 when her new found relationship with Sean began to flourish.  Thereafter, to the extent that the plaintiff had symptoms of pain, depression and anxiety they were the result of the various other ongoing stressors in her life, primarily the breakup of her relationship with Greg and the pressures of her Master’s program.

[207]     I find that the Second Collision again exacerbated the plaintiff’s pre-existing physical pain symptoms for no more than several weeks.  The Second Collision also exacerbated the plaintiff’s anxiety symptoms, which over the ensuing period of weeks and months became conflated with the plaintiff’s pre-Collisions anxiety and other psychological issues.

[208]     It is, in my view, noteworthy that Sean described the plaintiff as a happy, calm and fun-loving person who showed no signs of physical pain or psychological symptoms until December 2012 when he told the plaintiff during an argument that he was leaving.  Her reaction on this and subsequent arguments was uncontrolled rage akin to a “caged animal” where the plaintiff threw things at him and tried to bite him.  None of the medical experts were made aware of this behaviour.  Sean was oblivious to any pain that the plaintiff claimed to be in until they returned from Europe and went to counselling together, at which point he concluded that her behaviour was due to her being in pain.

[209]     However, there is no evidence linking the plaintiff’s violent episodes to the Collisions.  If the plaintiff’s uncontrolled rage and physical violence were the result of her Collision-related pain, one would have expected her to have so advised the medical experts.  Instead, no mention was made to the experts of those episodes.

[210]     I find that, as the plaintiff continued her Master’s program, the plaintiff’s pre-Collisions psychological symptoms increased and those caused by the Collisions diminished.  By April 2013, the predominant, if not entire cause of her ongoing physical pain and psychological symptoms was unrelated to the Collisions.  The plaintiff admitted advising one of her doctors, Dr. Feldman, in January that “anxiety as a result of a family problem, depression particularly in July 2013 and occasional panic attacks” were her most significant problems.

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