Traumatic brain injuries

Issue: BCMJ, vol. 60 , No. 10 , December 2018 , Pages 503 WorkSafeBC

Between 1990 and 2017, WorkSafeBC accepted 30 170 new traumatic brain injury (TBI) claims, of which 98.4% were diagnosed as a mild traumatic brain injury (MTBI). The average age of the claimants was 38 years, 68% were male, and 95% returned fully to their job after a short period of time away from work.

TBI, often called an invisible injury, is quite common. The US Centers for Disease Control and Prevention has identified the leading causes of TBI as falls (28%), motor vehicle traffic accidents (20%), struck-by or -against events (19%), and assaults (11%). Of the total reported TBIs, 75% to 90% fit the categorization of MTBI. About 90% of those diagnosed with MTBI follow a predictable course, experience few, if any, ongoing symptoms, and do not require any special medical treatment. Of the more than 1.1 million patients with MTBI who are treated and released from an emergency department annually, only about 10% experience postinjury symptoms of a long-lasting nature.

WorkSafeBC’s Special Care Services Department has a team comprising experienced case managers and clinicians who are responsible for managing all new claims and the majority of existing claims for injured workers with a severe brain injury. Special Care Services case managers remain with their clients for the duration of their claim, monitoring the worker’s progress from the date of injury to the initial adjudication and beyond.

Each worker’s situation is unique, and our staff members strive to provide the services and support to best meet the individual needs of each client and their family. Health Care Services collaborates with services and providers whose key priorities are to assist clients in gaining and maintaining independence in self-care, and developing return-to-work plans, when appropriate.

The following WorkSafeBC services are designed specifically for workers who have sustained TBIs:

  1. Community Brain Injury Services—strives to maximize and maintain skills in self-care, productivity, and leisure that allow injured workers to live, participate, and work in their local community. Services are provided in the home and community to assist these workers in gaining and retaining independence, and maintaining positive relationships. Our occupational therapists develop plans and may delegate care to support workers under the supervision of a community occupational therapist.
  2. Residential Care Services—helps workers gain and maintain skills in self-care, productivity, and leisure that allow them to live, participate, and potentially work or volunteer in their local community. Provides physical, cognitive, and psychological services, as well as appropriate behavioral interventions, to a diverse group of workers with varying degrees of function and dependency, including those who need 24-hour supervision. A qualified contractor may provide these services in a facility or family care home.
  3. Head Injury Assessment and Treatment Services—a multidisciplinary, early intervention program that provides assessment and treatment services for workers who have sustained a mild-to-moderate head injury, with a goal of return to work. This in-clinic treatment service is offered by teams consisting of physicians, psychologists, neuropsychologists, occupational therapists, and physical therapists, with locations in Kelowna, Surrey, and Vancouver.
  4. Home Care—a contracted network of community home-care providers who offer short-term and long-term home support and nursing services in the worker’s home and/or community setting, and focus on assisting with activities of daily living, personal care, and professional nursing services such as wound care.
  5. Vestibular Physiotherapy—provided by physiotherapists in the community who have training in vestibular rehabilitation and offered as a single service or concurrently with other treatment services, as required. They assist in treating vestibular dysfunction such as vertigo, dizziness, visual disturbance, or imbalance.

If you have an injured worker patient with a TBI and require further information or assistance, please contact a medical advisor in your nearest WorkSafeBC office.
—Andrea McNeill, BScOT, BA Psych, OT(C)
Quality Assurance Supervisor, WorkSafeBC Financial Services & Health Care Programs
—Lori Cockerill, MBA, BScOT, BScPsy
Manager, WorkSafeBC Client Services—Special Care

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This article is the opinion of WorkSafeBC and has not been peer reviewed by the BCMJ Editorial Board.

Andrea McNeill, BScOT, BA Psych, OT(C), Lori Cockerill, MBA, BScOT, BScPsy. Traumatic brain injuries. BCMJ, Vol. 60, No. 10, December, 2018, Page(s) 503 - WorkSafeBC.



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