Post-traumatic stress disorder (PTSD) compensation claims

• Flashbacks (intrusive or recurrent memories)
• Nightmares
• Disturbed sleep, restlessness and agitation
• Fatigue
• Avoidance of certain situations that remind a person of a traumatic event
• Anxiety
• Poor concentration
• Butterflies
• Panic attacks
• Negative thoughts and feelings such as feeling under threat or loss of confidence
• Hyper vigilance (increased alertness and awareness)
• Exaggerated startle response (over-reacting to certain situations or “triggers”)

The NICE guidelines suggest Trauma Focused CBT (Cognitive Behaviour Therapy) or EMDR (Eye Movement Desensitisation Reprocessing).

CBT is a talking therapy that can help the injured person manage their problems by changing the way they think and behave. It is most commonly used to treat anxiety and depression but can be useful for other mental and physical health problems including Post-Traumatic Stress Disorder. It focuses on how the injured person’s thoughts, beliefs and attitudes affect their feelings and behaviour and teaches coping skills for dealing with different problems.

EMDR is a psychotherapy treatment that was originally designed to alleviate the distress associated with traumatic memories. The treatment enables the injured person to heal from the symptoms and emotional distress that are the result of disturbing life experiences. It involves a set of bilateral movements with the individual being asked how they feel. This process continues until the memory is no longer disturbing. The individual is processing the trauma with both hemispheres of the brain stimulated.

What works for one person may not work for another person, therefore it is important to discuss with your Psychotherapist what the treatments are, as one person may benefit from one type of treatment or a combination of CBT and EMDR.

If the condition is treated early or effectively enough (ie when the injured person feels ready to start treatment), then most people will make a full or partial recovery to the extent that the condition no longer impacts on daily life, work and relationships.

We know from the experience of some of our clients that occasionally they do not recover because their condition is so severe and chronic. However, most clients find that treatment really helps them to be able to participate in life again.

Many clients state that they have to adapt and change certain aspects of their life, for example going to the supermarket at quiet times, doing work which does not involve being in contact with too many people, using breathing techniques to avoid anxiety or panic attacks.

Many of our clients suffer PTSD as a result of the trauma they experience in accidents, whether they have suffered minor or serious, life changing injuries. Psychological injury forms a significant part of our day to day case handling. Our clients often say that they find it easier to cope with their physical injuries than their psychological injuries.

Psychological injury can arise from the trauma of an accident, the impact of the accident on their life, for example, loss of job leading to financial worries which causes depression, or the daily reminder of an accident through the physical scars they bear.

Many of our clients are involved in road traffic accidents, whether as drivers or passengers involved in collisions with other vehicles, or cyclists and pedestrians. However, we also represent a variety of workers such as military personnel, care workers, nurses, teachers, firemen and police who suffer injury during the course of their employment, and members of the public who are injured in public places, such as parks, playgrounds and shops.

The impact of PTSD and other psychological injuries should not be underestimated as this can impact family life, social and recreational participation, work and daily living. Psychological injury can affect an individual’s ability to do their job and lead to financial loss. For example, if a healthcare professional is assaulted by a patient due to an employer not implementing a safe system of work or safe environment, the individual is often too frightened to return to the workplace either temporarily or permanently which can lead to loss of earnings and lifestyle.

If you think you have PTSD it is advisable to speak to your GP who may prescribe medication to help manage symptoms (particularly as PTSD can often be accompanied by Depression and/or Anxiety), and/or refer you for counselling. The NHS tends to have a long waiting list for psychological treatment and it is not always possible to see a counsellor or psychotherapist on a 121 basis due to limited NHS funds and resources. Private counselling can be costly.

Our solicitors have a good understanding of psychological injury and how it can impact on everyday life and function.

In a personal injury case it is vital to instruct specialised solicitors in the field to ensure that the right medico legal expert is instructed in the case to correctly diagnose the psychological condition. Just feeling scared or anxious or stressed is not enough to be compensated as the condition must be a recognisable psychological condition. It is also important to find a solicitor who can provide you with access to treatment as soon as possible to help in your recovery.  

We aim to ensure that our clients have access to private treatment as early as possible. If left untreated, PTSD and other psychological conditions can have a significant impact on everyday life. Many of our clients fear going out of the house which can impact their ability to work, see friends and family, go shopping or engage in social activities. It can impact on relationships and family dynamics and often cause the breakdown of relationships.

Psychological injury is often a component part of a much wider and complex presentation in the injured people we represent, particularly those who suffer complex musculo-skeletal injuries eg lots of broken bones and soft tissue injury resulting in ongoing pain.

Pain and psychological injury (eg depression and PTSD) will often have an impact on each other so that when someone is in pain they feel depressed, mentally and physically drained, which in turn heightens their pain and it becomes a vicious cycle. The result of this can be to affect sleep, memory and concentration, mood and function.

Having a solicitor who understands psychological injury and its interplay with other conditions is really important in terms of helping you to access the right and most suitable treatment and ensure that you receive the right amount of compensation.

Yes. For example, if a civilian suffers PTSD because they have been involved in a road traffic accident where they were injured as a result of the other person’s negligent driving, they can bring a claim against the other party’s insurers or via the MIB (Motor Insurers Bureau where there is no insurer or the driver is untraced).

In military PTSD cases, the principle of combat immunity applies, which means that military personnel cannot recover damages for PTSD via a civil claim against the MOD just because they have developed the condition due to the events they witness in their day to day job.

There needs to be some negligence on the part of the MOD, for example, this could be where there has been a diagnosis of PTSD and then failure to adequately treat, or failure to diagnose and/or treat. Injured armed forces personnel can make a claim for developing PTSD via the Armed Forces Compensation Scheme which is a separate, no fault scheme.

Symptoms experienced by individuals will be similar for example, nightmares and flashbacks, avoidance of situations that remind someone of the traumatic incident that led to their PTSD (triggers), being hyper vigilant and weary of certain situations, feeling emotionally numb, experiencing feelings of heightened anxiety, fear or panic attacks. However, there may have been a number of traumatic events before there is a clear and full diagnosis of PTSD. 

Often military personnel will not want to admit to having psychological issues as this may be perceived as weak by their peers and superiors. This may lead to alcohol or substance abuse as a coping mechanism or they may become verbally or physically abusive as they struggle to cope with their emotions.

It depends on the nature and severity of the injury, whether the responsible party admits liability, and whether the responsible party agrees to fund psychological therapy early to help the injured person to maximise their recovery and return to function.

In cases where PTSD is part of more complex injuries such as musculo-skeletal injuries, then it may take an injured person time to recover from the physical aspects of their injury through prolonged surgery and physical rehabilitation. In these circumstances, psychological therapy may be an ongoing process or something which is best left until there has been in improvement from physical injury.

If liability is not admitted and the case is complex, proceedings need to be issued at Court against the responsible party/ their insurers within the 3 year limitation period.  Once a case has been issued it can take up to 18 months to resolve.