O v. T – 25.10.17
PA and Personal Trainer recovers £1.5 m for severe post traumatic fibromyalgia/somatic symptom disorder. Marcus Grant, instructed by Alex Cohen of Brian Barr Solicitors, represented the Claimant.
Following a modest rear-end shunting road accident, an otherwise fit and healthy PA and part time fitness trainer sustained a whiplash associated disorder that interfered with her ability to work normally and resulted in her being unable to achieve restorative sleep. Being unable to work effectively caused her anxiety. Over the course of c. 4-6 months after the accident her whiplash symptoms transformed into a more widespread diffuse aching throughout her body coupled with headaches, mental fatigue and impaired cognitive function. Seven months after the accident a rheumatologist diagnosed fibromyalgia although features of her presentation did not fit comfortably within the diagnosis. Over the ensuing five years her health deteriorated, and despite having access to a bespoke residential pain management course, her function declined to the point where she became largely wheelchair dependent and acquired significant care and housing needs.
On her case her presentation was explained by post-traumatic fibromyalgia; the nexus between the trauma and the subsequent fibromyalgia was not simply a temporal one, but one involving a mechanism of trauma-induced non-restorative sleep, specifically an inability to achieved Rapid Eye movement (REM ) sleep. On her case, she did not present with any other self standing psychiatric disorder to explain part or all of her symptoms. The prognosis was poor and she would require substantial care and assistance for the rest of her life.
The Defendant’s experts considered that her presentation on physical examination of exquisite pain that made it impossible to conduct a structured assessment for fibromyalgia was more suggestive of a psychiatrically-mediated disorder rather than post-traumatic fibromyalgia, and considered that somatic symptom disorder best encapsulated that presentation. They considered that she presented with perfectionist and driven character traits before the accident that rendered her vulnerable to descending into an equivalent psychiatrically-mediated chronic widespread pain state in the absence of trauma, or within a short period of her 38th birthday (her age at the time of the car accident). Furthermore, they contended that because the predominant explanation for her presentation was psychiatrically mediated, rather than organically mediated, the prognosis for substantial, though incomplete recovery was good; the treatment modality of choice was CBT, coupled with a functional restoration programme.
The case settled on day 6 of a trial in the Queen’s Bench Division at a point between the Parties’ respective best case scenarios.