Your WCB Concussion Claim: The Final Chapter

The vagaries of WCB claim acceptance for concussion injuries

If you’ve been following along, the first two installments of this concussion series explored various types of brain injuries, the associated symptoms, and hinted at the obstacles to workers’ compensation benefits that these injuries often present. We’ve learned that when the head is subjected to strong forces, this can cause the brain to shift or move inside the skull. This sudden movement triggers chemical changes in the brain that can stretch and damage brain cells. This stretching leads to the leakage of potassium, a chemical that’s typically contained within the neuron, into the extracellular space. This in turn triggers an influx of calcium that enters the cell and causes vasoconstriction, leading to a decrease in cerebral blood flow and impaired brain efficiency.

The six different types of concussions that we’ve reviewed, each with its own set of characteristics and challenges, include symptoms ranging from mental exhaustion and difficulty thinking, to issues with balance, eyesight, hearing, and even anxiety. But unfortunately there are major challenges with respect to concussion diagnosis and treatment. Currently, there is no blood test, serum marker, or imaging technique that can definitively diagnose a traumatic brain injury. Concussions are not visible on MRIs or CT, making conclusive evidence of TBIs something of a unicorn. The difficulty lies in the nature of concussions being at the cellular level, presenting as an energy crisis without structural changes in the brain.

WCB claim denied

The Board bases benefit eligibility on confirmed diagnoses, with a significant emphasis on objective evidence of an injury or condition. In many cases, if your injury can be visualized through imaging tests such as MRI, CT scans, or X-rays, or identified through diagnostic procedures like EMG (for nerve function), EKG, or ECG (for heart function), your claim is more likely to be securely grounded. These objective tests typically provide clear, verifiable evidence critical for the acceptance of a claim.

However, traumatic brain injuries, including concussions, present a unique challenge. They can cause microtears and other cellular damage that often elude detection by these standard imaging techniques. This raises a crucial question: Will the WCB deny your head injury claim? The answer varies. If the injury is demonstrably work-related and medical attention is promptly sought—particularly if the incident involved loss of consciousness—the claim may initially be accepted. According to Alberta’s recovery duration guidelines for concussions, symptoms are expected to resolve from days to weeks, with a general anticipation of return to normal within about 4 weeks. Consequently, when WCB accepts a TBI claim, there’s an implicit expectation of fitness for work within this timeframe.

Recovery from a concussion, however, doesn’t always align with these expectations. If symptoms persist for months or evolve into chronic conditions, claimants find themselves navigating a complex landscape. The “recovery manual” might suggest a swift improvement, but prolonged or permanent symptoms complicate the situation. In such scenarios, there’s a risk that the WCB could perceive ongoing symptoms as psychosomatic or accuse claimants of “over-reporting” their conditions—a euphemism for exaggeration.

Where-to from here?

If your concussion claim has been denied or if coverage was terminated despite ongoing symptoms, you’re not without recourse. Here’s a structured plan to navigate through this challenging time:

Be Mindful of the Appeal Deadline: Remember, you have one year from the date of the entitlement decision to file an appeal. It’s crucial to mark this date on your calendar. Missing this deadline means forfeiting your right to appeal.

Ensure Continuous Medical Documentation: If you haven’t been sending regular medical updates to the WCB, it’s time to act. Schedule appointments with your doctor, physiotherapist, or chiropractor. During these visits, emphasize that your injury is work-related and request that detailed notes on your symptoms, along with your claim number, be forwarded to the WCB.

Proactively Communicate with WCB: After your medical appointment, reach out to your case manager or claim assistant at WCB. Inform them of your recent medical consultation, provide the clinic’s contact information, and request that they follow up for the medical report. Although this might seem redundant, it’s a necessary step to ensure your claim remains active and properly documented.

Deciding on the Appeal Process: When ready to appeal, you face a choice. You can initiate the appeal process independently by downloading the G040 form from the WCB’s website, completing it, and emailing it to contactcentre@wcb.ab.ca. Alternatively, for complex cases involving brain, back, or psychological injuries—where the stakes include your livelihood, career, and long-term health—it’s advisable to seek professional assistance.

Complex injuries demand nuanced understanding and advocacy that experienced WCB representatives can provide. While minor injuries might be straightforward to appeal on your own, the intricacies of serious conditions warrant expert support.

Seeking Expert Assistance

For those facing the daunting prospect of appealing complex injury claims, professional guidance can make a significant difference. At Blue Collar Consulting, we specialize in assisting workers through the appeal process, offering expertise in managing claims for serious injuries that impact your future. Visit our website at BlueCollarConsulting.ca for more information on how we can help you navigate this critical juncture.

Call (780)-340-5727 to speak with our 541 Eagleson Wynd, Edmonton T6M 0Y4 team for free.
Ben Barfett

Ben Barfett

Ben Barfett, Principal and Consultant, has spent his life in the construction sector, specifically heavy civil, enviro, commercial, and energy. Having held senior roles in business development, technical advisory, and regional management, he earned his stripes in the field and in head office. Conscious of the interplay between commercial, legal, and execution aspects of construction, his business insights are informed by expertise in WCB policy and enhanced with disability-specific training.

Ben Barfett

Ben Barfett

Ben Barfett, Principal and Consultant, has spent his life in the construction sector, specifically heavy civil, enviro, commercial, and energy. Having held senior roles in business development, technical advisory, and regional management, he earned his stripes in the field and in head office. Conscious of the interplay between commercial, legal, and execution aspects of construction, his business insights are informed by expertise in WCB policy and enhanced with disability-specific training.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

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