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Dr. Charles Tator
Dr. Charles Tator, Director of the Canadian Concussion Centre, uses a model to talk about what happens in the brain when it is concussed. He says that people living with long-term symptoms from a concussion need adequate time to get back to regular life – a point he will underline at tomorrow’s symposium. (Photo: UHN)

"It's frustrating when I see people like myself who are really suffering, who then have to deal with insurance companies making decisions that further impact our health."

That's the message Derek Nischan is bringing to an event tomorrow hosted by Toronto Western Hospital's Canadian Concussion Centre (CCC) in partnership with the Ontario Law Society.

Derek will be part of a patient panel at the "Concussion Symposium for Lawyers, Insurers, Judges, and Clinicians." It's intended to give attendees an inside look at the struggle of living with persistent concussion symptoms – and underscore that the challenge for someone to get their condition recognized by insurance providers, for example, can often be equivalent to recovering from the injury itself.

The symposium's goal is to better inform these professionals about the many nuances and challenges of this brain injury to make it easier for patients needing to navigate the legal/insurance/court systems as they deal with issues related to their concussion injury.

It's a double-barreled burden that Derek knows well as life as he knew it quickly unravelled after a skiing accident in January 2016.

Logo of Canadian Concussion Centre  

An avid athlete all his life, Derek had had a few concussions before, but never experienced any lasting effects. But when he crashed while skiing at Blue Mountain, a collection of debilitating symptoms quickly took hold, preventing him from doing pretty much anything.

"After the accident I hid in my room," Derek recalls. "I had horrible headaches every day, I couldn't handle light and every sound in the house echoed painfully in my head."

"Picture a large man's hand slipped inside the back of your skull – that's what the constant pain feels like. Then picture that same hand using your brain as a stress ball, that's the debilitating pain."

'I approached this like a stubborn athlete – just work through it'

Unable to work, Derek stayed home from his job as a high school teacher in an effort to recover. He consulted his family doctor and saw specialists for strategies to cope with his persistent symptoms.

The headaches persisted, and though sound and light sensitivity gradually became less of an issue, Derek was quickly fatigued and often nauseous from information overload.

Despite this, when the new school year started in the fall of 2016, Derek attempted to return to work on a reduced schedule, teaching one period per day. But even with the lighter workload, the activity only worsened his still terrible headaches to the point that he went home to sleep afterward.

"Even though I wasn't feeling great, I approached this like a stubborn athlete thinking I just had to 'work through it,'" says Derek. "But the brain is a part of the body where that just won't work, and I probably set myself back even further trying to force it."

After two months of trying, Derek conceded he needed more time to heal. Until then, he'd used a combination of sick days and sick leave for his time off. But when he went to claim his long-term disability insurance, his provider said his condition didn't qualify.

Over the next two years, a back and forth with his insurance provider unfolded with Derek giving them health records and paperwork from the number of specialists he consulted in order to appeal the decision – all while trying to manage his symptoms.

"The stress of the situation wasn't helpful to my condition," he says. "It felt like I was fighting a battle that didn't need to happen."

It's an all too common situation notes Dr. Charles Tator, Director of the CCC and one of the specialists Derek sought out for help with his symptoms.

250 professionals from various fields at symposium

"As doctors, we want our patients to return to work and to a regular life, but it needs to be done through a graduated process that has some flexibility so that the patient doesn't crash and have to start over again," says Dr. Tator. "These providers aren't always aware of what chronic concussion injury looks like, and we hope this symposium will make them more sensitive to the condition."

About 250 professionals from the various fields have signed up to attend the symposium, which will provide an overview of the fundamentals of concussion: how difficult it can be to diagnose, how symptoms persist among a third of those who get a concussion, and how gradual re-integration to stimulating environments like a work place is the best approach for a successful return.

Participants can receive credit through the Law Society or the Royal College for Physicians and Surgeons for attending, and a video of the symposium will also be made available for an online course.

Derek's back and forth with his insurance provider has certainly been trying.

Results from an MRI Derek submitted helped overturn the decision about long-term disability in early 2017, but later that year he was denied his benefits. More paperwork finally had those benefits reinstated and paid in arrears just this month.

However, that was not the end of the debate about Derek's health: his provider's definition of long-term disability has changed. His long-term funds have once again been denied and he is currently involved in another go-around to prove his need for continued financial support.

All of this while he works on recovery. Through support from the specialists, he has made small improvements and cautiously started taking on a few extra activities, such as helping to coach his daughter's volleyball team for an hour a week. It's a test to see how much he can handle and he certainly feels the effect of having done so.

And, Derek is also not out of the woods yet as patients recovering from concussion can experience setbacks that interrupt their recovery.

"Nobody pays for insurance hoping to use it," Derek says. "I'm an active participant in trying to get better and I want nothing more than to get back to the job and activities I love – but this is the best I can do right now.

"I hope by being part of this panel, I can provide a better understanding of what I'm going through."​

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