Restored migraine treatment for man injured in industrial accident

An injured worker in Annapolis Valley, Nova Scotia, whose therapy was discontinued in 2019, will now have Botox treatments for chronic pain covered for the next year after reapproval from the provincial health insurance administrator.

Mark Perry said he was initially relieved to have turned back, meaning he didn’t have to pay for the injections that help him cope with debilitating migraines, but he’s disappointed that he has to reapply for treatment every year, and fears that this could be the case again interrupted.

“This is a treatment I’ve had for almost a decade,” Perry said. “It’s not that with another year things will suddenly change and then everything will get better. I never get better.”

Perry was running a sheltered workshop in Waterville, NS in 2009 when wood was struck in the face by a lathe. The injury ruptured his eye socket and severed nerves on the right side of his face.

It took Perry more than 18 months to return to full-time employment. He works as a health and safety manager at Kings Regional Rehabilitation Center.

After trying various combinations of medications and nerve-blocking injections to no avail, Perry found that injecting botox into his face and scalp helped control migraine headaches, which were almost daily and could last for up to a week.

Mark Perry from Berwick shows where his migraines start behind his eye socket that was broken in an accident at work. June 8, 2021. (Jack Julian / CBC)

These treatments took place every two to three months and were paid for by the Nova Scotia Workers’ Compensation Board. However, in 2019, funding stopped abruptly and his doctor told him the injections were no longer approved by MSI, the provincial health insurance program.

Perry said he made dozens of calls to the Nova Scotia Workers’ Compensation Board (WCB), MSI, and its nonprofit administrator, Medavie Blue Cross, but no one could explain why his treatments had been suspended.

Perry went without treatment until the severity of his headache caused him to pay $ 1,700 to resume treatment from his neurologist in January.

Letter of Approval

After 15 months without botox injections, Perry considered quitting his job because of total disability. He called his MLA and CBC News which published his story on June 11th.

On June 16, Perry received a letter from Medavie Blue Cross dated June 7th approving his botox treatments for the next year.

“At first when I opened it … I was a bit relieved because I was waiting for approval the whole time,” he said. “But I was a little disappointed because … it’s only until next June.”

New application process

Perry said the new botox approval process involves several stages.

First, his Halifax neurologist has to apply for a billing code to buy the botox, a debilitating agent made from bacteria.

Once approved, the doctor will need to apply for further approval to give the injections. Once the WCB confirms they are paying for the procedure, the doctor can call Perry to book the appointment.

“I’ll be honest, there is stress and anxiety associated with it,” he said.

Botox is approved in Canada for the treatment of chronic migraines. (Dillon Hodgin / CBC)

Perry said his clerk at WCB said he had to apply early.

“For June, I should start in January. And that’s to avoid the same situation happening again,” said Perry.

Perry doesn’t think it’s fair that a worker with chronic illness should constantly have to seek treatment. He is also afraid that his treatments could be interrupted again.

“I’m still nervous,” he said. “I had almost a decade in my treatment without any problems, and then it just stopped. It could happen again.”

Fixes for the system

Perry believes the WCB must hire injured worker navigators to better support complicated files like his.

“There really needs to be changes and more advocacy for workers who are in the system and need that help,” he said.

A Medavie Blue Cross spokesman declined to comment on Perry’s case and the delay in approving his pain treatments.

“Due to our privacy policy, we are unable to speak to certain member or customer cases,” Caitlin Ferguson, a senior communications consultant, said in an email.

“Our customers and members are always welcome to inquire about their specific requirements or related questions.”