Injured? Here's How a Personal Injury Lawyer Can Help

Three weeks ago I was at a retail store and tripped over winter matting near the entrance.  I fell and broke my wrist.  Today an Insurance adjuster called me.  He said I was responsible to look where I was walking but he offered me $5000.00 to help me out as I have been off work.  I am on sick leave and have not lost any income.  Is there any reason not to just take the money?

Plenty of Reason.  Leaving aside what happened, and what you might be entitled to recover as a result of your injuries, it is always a good idea to consult with a Lawyer before taking a settlement proposed by an insurance company.   Insurance adjusters work for Insurance companies and they do not approach a settlement based on what you are entitled to.  They offer money based on the risk of what you might receive by way of an award.  Generally, they will try and settle a claim or potential claim for as little as they reasonable can in order to close off a risk.

‍A Lawyer will work for you. Many Lawyers offer a free consultation.  I find I ask a lot of questions and do a lot of listening during a consultation.  I try to give my client an understanding of the legal issues arising in their circumstances, and what the options are going forward.

‍Assert your rights. Over the years I have come to understand that people almost always benefit from at least consulting with a Lawyer before trying to settle with an insurance company.    There is a significant imbalance between a lone individual and a huge insurance company.  A Lawyer has the knowledge to help level the playing field.  In my experience insurers will see a greater risk when dealing with an injured person who is represented by a Lawyer.  Greater risk to insurers leads to better settlements.

What does "no fee unless you win" actually mean and how do most personal injury Lawyers get paid?

Answer: Taken literally and with knowledge of what goes into every account "no win, no fee" is a legitimate statement. That means: Yes, the Lawyer will not get a fee if you don't receive compensation. However, in addition to fees, there are also costs and disbursements.

Costs represent the defendant's legal costs that are due if you get an adverse judgment. These fall on your shoulders and not your Lawyers. Costs insurance can be available in some cases and should be explored in your initial meetings (the earlier you get it, the cheaper it is).

Disbursements are the funds paid upfront by your Lawyer to carry your file. They include things like photocopying, mail/postage, travel costs, filing costs and medical-legal assessments. A Lawyer can run up disbursements in the thousands and if successful, the defendant will pay the value of your claim plus these disbursements. However, if you're unsuccessful, these disbursements are typically due and owed by you. Meaning, if you don't "win" you owe the Lawyer what was spent to carry your file. Unpaid disbursements may also be covered through your costs’ insurance.

Most personal injury Lawyers work off contingency, meaning that they are compensated based on the result. They take a percentage of your settlement. That percentage is typically 30-35% depending on the Lawyer.

The fee isn't as simple as just taking a percentage of the overall settlement. It must be broken down in accordance with what a Lawyer is legally able to take. For instance, they cannot take more than the client receives. They cannot take "costs" which amount to about 15% of the value of your claim and are used to counterbalance your contingency fee.

Here's how it might play out:

Let's say the value of your claim is $100,000. In addition to the value of your claim, the defendant will have to cover disbursements (what was paid to run your file) and costs. A typical settlement could be broken down as follows:

• value of claim: $100,000
• disbursements: $15,000 (including HST)
• costs: $12,319.37
• DEFENDANT'S PAYMENT: $127,319.37

The Lawyer's fee is taken out of the value of the claim and not the defendant's entire payment. So if the contingency is set at 30%, the Lawyer's fee in the above example would be $30,000 + H.S.T.. The Lawyer will take the disbursements as well to cover the funds he or she spent on the file. You're left with the remainder. Here's how it works using the above example:

• defendant's payment: $127,319.37
• disbursements: (-) $15,000 (including HST)
• legal fee: (-) $30,000
• HST on legal fee: (-) $3,900
• IN YOUR POCKET: $78,416.37  

The exact calculation used could change depending on the facts of each case. As a note, claims are typically subject to pre and post-judgment interest at a variable rate. This will be added to the defendant’s payment.

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Somatic Symptom Disorder - What is it and how can we prove it?

The Supreme Court of Canada (SCC) recently crystallised the importance of considering how psychiatric injuries accompany physical ones. In Saadati v. Moorhead, Saadati was in a car accident and suffered psychological and emotional trauma. He was awarded damages for mental injury based on the evidence of a lay witness who explained that Saadati’s personality changed post-accident. Expert evidence was not necessary, and the award did not need an attached “recognizable psychiatric illness.” The court found that requiring mental injury to pass the threshold of medical-expert testimony showing a “recognizable psychiatric illness,” while not requiring the same “classificatory label” of physical injury, would amount to unequal protection for those with a mental injury.

This SCC decision confirmed that the law of negligence accords identical treatment to mental and physical injury. This is a decision that is often looked at, as of late, with an overwhelming increase in the diagnosis of somatic symptom disorder (SSD). In dealing with my fair share of personal injury cases, I’ve started to notice this increase. The criteria for the illness remain broad, and like so many other cognitive/psychological conditions, it tends to be met with quite a bit of push back from defendants.

The DSM-5 characterises the condition as follows:

“SSD is characterised by somatic symptoms that are either very distressing or result in significant disruption of functioning, as well as excessive and disproportionate thoughts, feelings and behaviours regarding those symptoms. To be diagnosed with SSD, the individual must be persistently symptomatic (typically at least for 6 months).”

I tend to see this diagnosis when clients are suffering from longstanding subjective physical symptoms. The client is in extreme physical distress, but there’s no explanation of where this additional distress comes from. The pain felt by the client is otherwise disproportionate to the actual seriousness of the injury. I’ve always viewed it as an uncontrollable dispute between the body and the mind. I say this because typically the body is ready to be healed but the mind isn’t.

The proof isn’t as solid as we wish it was. The driving force of the diagnosis is the client’s own reaction to assessment and medical investigation. An SSD case can often be met by an assumption of “fake” injuries or plaintiff malingering. However, the SCC worded it properly when stating that the trier of fact should “not [be] concerned with the diagnosis, but with symptoms and their effects.” This point should always be emphasised when dealing with SSD cases. Focusing on the genuine statement of lay witnesses and providing a clear historical approach of the impact caused by the negligent act, remains the best means to put forward a strong SSD case.

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