Can Any Part Of Ptsd Be Considered A Physical Injury? Insurance Fight!

[blwnawy]

Please I need help.

Can Any Part Of Ptsd Be Considered A Physical Injury?
(Mine was caused from a massive explosion at work where I should in all reality be dead.)

Eg: Evidence of physical changes to the brain etc.

I know there will be plenty of opinions but please I need fact based info. We are dealing with lawyers and doctors.

Two and a half years and I am now trying to fight an Insurance Company on my own as legal representation have pulled out as the next step for them is court. They would like to fight it but the policy wouldn't cover a lawyers costs to take it there and we ourselves can't afford it. We are currently trying to resolve it with a disputes resolution.

It has become more a matter of principle for me and for others like me.

They are now falling back on the on the fact that it needs to be a physical injury resulting from said accident. My wife and I have been trying to research this online but are running out of time.

I am sorry I have turned back up out of the blue asking for assistance but I can't deal with my own life and don't feel like I'm much help to others. I've tried but found it too draining.

Thank you

Note: Contrary to the flag on my avatar, I'm an Aussie and this is an Australian insurance company in case you are wondering. Any info from any country would be greatly appreciated.

 

[seedling]

Sorry you are going through this. This is the place to ask for help. There may be others who have an angle on this.
You may have some basis in the fact that PTSD is caused by an experience. Seems that you could argue it is an injury. Brought on suddenly by what happened to you.

What about the physical symptoms that you face and that need to be treated? Any opening there? They were caused by the experience.

My own experience was that my PTSD was caused by my son nearly being killed. In our state in the US, I couldn't file an insurance claim for myself because PTSD comes under the heading of an emotional injury. To file for emotional injury I would have had to be a witness to him being shot. I arrived a few minutes later. Our lawyer said the case would have been one that would have to rewrite the law to be successful.
We filed a claim and won damages for our son. "Won" truly is the correct word to use. It was a fight.
We went to mediation in the end (like you - after 2.5 years), it was much better than going to court might have been. Our mediator was brilliant. Our lawyer was there as well. Both sides were represented. It was the last resort before a court date and trial (with another 6 mo. wait for that).

They are going to know that the PTSD was caused by the explosion. They will also try to cite whatever law is favorable to them. Can you find out if PTSD is defined there as specifically an "emotional injury" or is there some gray area?

Good Luck! Hang in there, stand your ground.

 

[blwnawy]

Thanks seeding, it's really hard aye. We're thinking of you.
They are just worms, I really wish this was over with but part of me can't give up.

 

[Ocean5]

I'm not a lawyer, but maybe you could turn case around on them. Tell them to provide "legal proof" the brain/mind are "not" part of the physical body. Tell them you want scientific based evidence. Not just some "paid off" expert to testify. Tell them you want sources cited from scientific papers or journals.

In Australia do some lawyers do Pro Bono work? Even just to advice you?

Not sure it will help, but under new health insurance laws in U.S. under Obama Care. Mental health is treated just as any other injury or illness.

Also, check with your government agency that handle's veteran's health care. They maybe be able to direct to material showing it's an injury.

Also, maybe contact traumacenter.org for advice. Their founder Dr. Bessel Kolk is suppose to be leader in ptsd and trauma. When I am well enough I plan to read his book "The Body Keeps Score"

I feel for you, and wish you the best. Stay strong.

 

[Biz]

Have you been evaluated for a Traumatic Brain Injury? I don't know a lot about TBI's, but I do know two guys who went to war and were near IEDs; they both have a TBI and PTSD. From what they've said, the TBI makes the PTSD symptoms worse.

 

[Sighs]

@Ocean5 - if you are the plaintiff in the case then the onus is on you to prove your case - the defendant does not have to prove anything.

@blwnawy - What state are you in? Are you trying to claim on an insurance policy? If so, then it depends on the policy wording. Have you made a claim in negligence? It happened at work - so this is a worker's comp claim? I don't understand why they are arguing your injury has to be physical as 'pure nervous shock' cases have been around for years and have been affirmed by the High Court. Were your lawyers no-win no-fee? Why are they backing out now? Have you tried to get other lawyers?

 

[joeylittle]

@blwnawy - unless there is some specific reason why you need to restrict/connect PTSD to being a 'physically prove-able' condition, then I'd suggest your best course of action would be to get a full neurological work-up.

There is early research that shows changes in the brain, yes, but none of that has really been brought together by the scientific community in a way that would hold up in court (I don't believe).

But, if you have changes to the brain as a result of proximity to a blast (as @Biz mentioned), then you'd have a case.

I'm sorry for what you are going through, it sounds frustrating.