A word or two about ICBC
ICBC’s “Enhanced” Care
For the most part, this is ICBC’s euphemism for paying for therapy. They also have wage top-up to 90% of salaries to $113k, but mostly it means payment for community-based therapy. My experience with this has been both good and not so good, but as I’m still in the middle of therapies, I’ll probably wait to comment until I’m closer to the end of them. What I will comment on now is something that happened while I was still convalescing in GF Strong.
At some point not long before your discharge date, a family meeting occurs, and it includes all therapists you’ve seen while in rehab, any affected family members, the attending physician(s) and, nominally, third parties like ICBC. Attending on their behalf was a support and recovery specialist and his manager. The ICBC line is that they want to ensure your support in the transition back home, all the way through your eventual return to work. In this specialist’s case it seemed more like they wanted to ensure maximum mis/disinformation.
Of course for all attendees’ benefit we were assured by him and his manager that ICBC’s financial support of necessary therapies would only begin when I was discharged (a point the attending physician made his manager repeat for all to hear). This is important because ICBC only pre-approves 12 weeks of therapy. Later, by email, he then insisted that he and his manager had misspoke, and the 12 weeks began from the date of the accident. This would render their financial support nearly useless, as I ended up in hospital for eight weeks, between RCH and GF Strong. Had I been limited to a mere four weeks of therapy, my progress would have been limited in the extreme.
As an aside, one thing I’ve found very odd in dealing with ICBC for therapy payment is their over-reliance on family doctors. In fact, our original specialist wanted all assessments and treatment plans to come from our GP, as opposed to the therapists who actually do the treatment plans, assessments and therapies. In many cases a GP won’t know what any of this really is, and will have to reach out to the therapists for updates. In short it just creates another barrier to things happening quickly. More important still, a GP has little to no expertise in acquired brain injury rehabilitation.
Turns out, the stuff the specialist was spouting was complete BS. My case was thankfully handed off to a senior support and recovery specialist, who has placed no such limitations on my therapies. The OT we hired (who’s excellent, BTW) thought he was inexperienced because ICBC usually approves therapy as needed for much longer than 12 weeks. While this has thankfully been the case, even just allowing someone to spew incorrect information like this is very damaging and introduces completely unnecessary stress for people already frazzled and typically in a very vulnerable place. In my case, I’ve just had speech therapy approved (mostly for executive functioning like complex planning and memory improvement) and additional vestibular physiotherapy beyond the 12 weeks will also be requested. I’ve also had to sign the medical information releases you’d expect, giving ICBC access to my post-crash medical history.
ICBC Bike Claim
After opening a claim within a couple days of my crash, my wife was simply ignored by the assigned adjuster. She periodically added information and occasionally asked for some sort of update as to progress. The adjuster couldn’t be bothered with so much as just an acknowledgment, let alone a real update. We heard absolutely nothing for about 17 weeks, until a couple weeks ago. I had escalated the lack of communication through social media first, then ICBC’s Fair Practices Office. After that I finally received an email from the adjuster’s manager. In it, she never apologized for his ignoring us for over four months, nor explained why, but did promise to get back to me the following week (over a week ago now) with an update on my claim.
It’s no big surprise that the ICBC manager never followed up, but as I did have her email address, expected to be bugging her regularly. I still maintain that 17 18 weeks is far too long to take to settle a claim for a written-off bike and a pair of carbon wheels.
More ICBC Nonsense
In a development that should come as a surprise to absolutely no one, there were still more delays from ICBC. Immediately after the adjuster’s manager said they’d get back to me the week before last, this past week they went on vacation for two weeks. Not only that, but at virtually the same time as I got their out-of-office auto-reply when I followed up with them, the Fair Practices Office, with whom I had escalated my claim a couple weeks ago, responded to me. In particular, as I had suggested there was no deterrent for people who drive carelessly, they assured me (with absolutely no supporting evidence) that “fault still matters” and more laughable still, that the system still has “the same incentives” to drive safely. Never mind that no-fault insurance literally removes those incentives by banning the ability of customers to sue for injuries and damage, no matter how bad they may be. Wrongful death? Careless driving causing death? Manslaughter? Lifelong, permanent and/or severe injuries? Brain damage? Never fear, as the system includes the same incentives it’s always had, minus, of course, any ability to be compensated for one’s injuries in any way. And sorry, but in many cases, ICBC footing the bill for some therapy sessions isn’t going to cut it at all.
What follows is their email and my response.
Suddenly, Settled
Almost as if the snarky reply above actually worked, on August 22nd I received a call from the adjuster. Again, no explanation for ghosting us and no apology, but (drum roll please) a settlement offer. I’ll receive nearly $7300, which is almost what I paid for the bike and wheels, minus the tax. I’ve signed the acceptance letter and will hopefully receive a cheque soon. I’ve been burned enough by ICBC that I won’t count my chickens before they’re hatched, though.
Note: I asked him to let me know when the cheque is mailed and have heard nothing so far in well over a week.
No more hand Therapy
This change had been coming for a while, as I’ve been plateauing with the therapy while the hand continues to progress slowly. Really, if you’re doing all the exercises and still seeing improvement, there isn’t a lot more the therapist can do in this case. Beyond working a little on the continuing stiffness, using the hand continually for nearly everything (as I do) is really the best therapy. I continue to see improved function, fine and gross motor skills, with drumming, typing and printing all continuing to see slow, steady improvement. I’d imagine I’ll get to a certain point where progress will be pretty minimal, but thankfully I’m not there yet, and, as always, my goal remains to get as close to where I was before the crash as possible.
A Word on Running and Cycling
There’s a litany of data supporting the benefits of cardiovascular exercise on recovering from an acquired/traumatic brain injury. People recover faster and show more improvement in their cognitive functioning overall. It’s very slow, but my vestibular symptoms seem to be lessening just a little bit. I still experience the brain “fog” but fewer things trigger the symptoms now, than when I came home from GF Strong.
I’ve also decided to do my best to do either a run, e-bike or trainer ride most days, with Mondays off. I’m hardly in training mode, but the only way I figure I can reduce my vestibular symptoms as fast as possible is to continually desensitize myself by triggering them. It’s what all vestibular physio is based on, and running is a particularly big trigger. The symptoms aren’t unbearable but they certainly aren’t minimal, either. I usually have to stop a few times while running, so working toward longer periods of continuous running is also a goal. I can do 4-5k without stopping, at roughly a 6:00/km pace. I’d like to get that up to 8-10 k eventually, but I’m nowhere near that right now.
My trainer rides are currently clocking in around 35-45 minutes. I’m not worried about power output or distance at all, just easy intervals at recovery (or a tiny bit better) pace. I did an hour a few weeks ago and realized that I needed to back off significantly to make the rides doable. It always slips my mind just how far I’ve come in the 18 weeks since the crash, and that I need to be patient. So, with both runs and bike training, I’m focusing on increasing duration until I can do either for an hour comfortably and only then increasing the intensity.
In the past four weeks
If nothing else, I’m not going to regress in my recovery because I didn’t put in the effort. The list below also doesn’t include my therapies or homework, which probably average about an hour a day.
- Run: 33km
- Walk: 50km
- Cycling (trainer & e-bike): 178km
- Weights: 4.5 hrs
- Yoga: 4.5 hrs
- Drums: 9 hrs
Long-term Disability
We are currently in the process of completing my LTD application. I’ve actually found the forms to not be as onerous as some of the horror stories I’ve heard of long, multi-page applications. Simply put, it requires signing for access to all medical records, a detailed description of the injury/illness, a commitment to inform the insurer of any change in circumstances or things like travel, a doctor’s statement, which similar to ICBC, seems to expect more knowledge of my therapy than my GP possibly could and a list of every specialist, doctor or therapist we’ve consulted as part of the injury/illness. In my case, that’s a very long list, particularly from my time in ICU at Royal Columbian Hospital. It’s probably not worth commenting further until I (hopefully) qualify for LTD.
I’ll not comment further on this until I know more about my LTD claim, likely after the fact.