Author Archives: Admin4

He was also examined in independent assessments at the request of TD by Dr. Howard Platnick, M.D., a family physician, and by Dr. Paul Kelly, Ph.D., C. Psych.  Both assessors found the Applicant to be co-operative and to have not exaggerated or overstated his symptoms.

Dr. Platnick was qualified to give opinion evidence as a family physician with an expertise in chronic pain and neuromusculoskeletal medicine.  He prepared a General Practitioner Insurer’s Examination Assessment Report[18] dated August 21, 2014 (“2014 Report”) and an Addendum Report dated November 12, 2015[19] (“2015 Addendum”).  He concluded in his 2014 Report that the Applicant had suffered a cervical myofascial strain WAD I and a lumbosacral myofascial strain but there were no valid indicators to support ongoing musculoskeletal, neurological or orthopaedic accident related injury or impairment.  His opinion was that the injuries satisfy the definition of minor injury and there was no pre-existing medical condition to prevent the Applicant achieving maximal recovery within the MIG.

Dr. Platnick set out the Applicant’s complaints and commented that they did not include any radicular symptoms, that is, no weakness, numbness or tingling.  In his evidence, he described neck and back pain as very common conditions in society in all age groups.  He testified that there is reliable testing available to confirm radiculopathy and nerve issues but none had been done here.  His opinion was that:

a)      the Applicant’s injuries due to the accident would have resolved with the four to six months of treatment he undertook;

b)      he saw no benefit to the Applicant having additional treatment;

c)      the Functional Evaluation Assessment was not reasonable or necessary as there were no findings in his assessment to justify it;

d)     the Workplace Assessment was also not reasonably required as there was no evidence in his examination of the injuries from the accident;

e)      the report of Dr. Balkansky did not give him enough information to support the conclusion;

f)       some of the tests that were conducted by Dr. Balkansky were screening tests, not diagnostic tests; and

g)      to diagnose radiculopathy he would need to see reflexes impacted, sensory loss, and muscle wasting.

I do not accept Dr. Platnick’s opinion for a number of reasons.  Dr. Platnick stated in his report that at the assessment, the Applicant had pain but no tingling or numbness in his arms, hands, legs or feet.[20]  Dr. Platnick’s testimony was that when he saw the Applicant his injuries were “cured” and he had only pain – not tingling or numbness in his hand.  He said that if there were later tests indicating other symptoms, then those symptoms are not connected to the accident.  This evidence is in stark contrast to the record by Dr. Paul Kelly, the psychologist, who saw the Applicant on August 7, 2014, about a month after the assessment by Dr. Platnick.  Dr. Kelly set out in quotation marks the Applicant’s statements to him that he got numbness and cramping in his fingers almost every day since the accident and that his back pain has been the same since the accident but the neck pain and pain in his leg does not bother him anymore.[21]

Also, Dr. Platnick’s recollection was that the description of the accident led him to believe that it was not severe.  In his view, a severe accident was a rollover or an intrusion into the cab of the vehicle or a car ripped apart.  He said that it is not surprising to find that a 1991 vehicle would have the seat brackets shifted in an accident.  The Applicant and his passenger both characterized the accident as severe and while the accident was not as severe as those described by Dr. Platnick, we are not dealing with a catastrophic injury claim as might well result from the accidents he described.  I accept the evidence of the witnesses who were the victims of the impact.

Even if this was not a severe accident according to his definition, Dr. Platnick agreed that radicular symptoms could develop even in a minor accident and that you could have radicular type of pain without having radiculopathy.  Given that potential, there are too few measurements in his report to support his conclusion.  Also he testified that, if there was radiculopathy in the patient’s history, he would have taken more measurements but he regarded this as a straightforward, non-complicated case.

Dr. Platnick testified that the objective testing for radiculopathy starts with symptoms of pain going from the neck or back to an extremity and the objective testing would be done for reflexes, sensory tests, nerve root tension signs, loss of strength and muscle atrophy.  His opinion was that if a patient had none of the five test responses, then there was no radiculopathy; if he had one of those five plus clinical symptoms then he could have radiculopathy.  These statements support the Applicant’s case as he complained of numbness and tingling, and not Dr. Platnick’s conclusion.

Dr. Platnick’s assessment included review of the documents supporting the treatment plans including the review of the Balkansky 2015 Report.  That review must necessarily have been limited because Dr. Platnick was not familiar with all the tests that Dr. Balkansky referred to as support for his conclusions.