A Vancouver woman who was injured in a car crash says she’s been stuck in a long, tedious limbo with ICBC over covering the costs of expensive private treatment.
Krystal McKay told Daily Hive her pain specialist has recommended ketamine infusion therapy to help relieve her pain, which would cost $31,000. However, she said the insurance company has dragged out its decision, leading to her losing her teaching job, missing out on key moments with her son, and impacting her mental and physical well-being.
“I’m just getting worse,” the 36-year-old said.
According to McKay, on October 2021, she was heading southbound on Main Street when a vehicle on E 64th Avenue, heading in the opposite direction, blew past a stop sign to turn left. Her SUV and the car collided, and she said her vehicle was not drivable afterward.
Before the crash, McKay had upper back pain and fibromyalgia (a condition that she said caused widespread pain all over her body), but it was “under control.” Unfortunately, the crash exacerbated her pain, and her doctor said it led to a spinal compression, she added.
She explained that her injuries from the crash have meant sitting and walking for long periods has become uncomfortable. And McKay added that for the past few years, she’s also depended on forearm crutches or a wheelchair to get around.
“It’s horrible,” she expressed.
“Every single day, I’m starting at max capacity in terms of the [pain] threshold, fatigue, patience.”
Life turned upside down
Krystal McKay playing with her son before the 2021 crash | McKay lying on the couch (Submitted)
Prior to the crash, McKay worked at a local high school and as a social media influencer, which supplemented her income. “I was working more than full-time and doing really well before this accident,” she said.
McKay said if you asked any of her friends, they would describe her as the “life of the party,” an “extroverted person” who loved to play poker and go to dinners. However, for the past few years, McKay has said she’s been “a hermit.”
“[The crash] has changed my personality. I feel I have recluse craziness going on in my head because I’m unable to be who I used to be and what I thrived and survived on,” she added.
After 15 years of teaching and a passion for her work, McKay was not able to return after the crash. She said the news that she was let go was devastating, adding, “I was crying for quite some days after that phone call because it was, like, the best school I’ve ever worked at.”
“It’s a job you can’t replace or replicate,” she said. “It’s been really hard. Also makes me feel like I’ve lost myself in that sense because I don’t get to do what I love to do.”
The greatest hurdle since the crash has been the pain and depression, which has impacted her ability to be able to care for her now five-year-old son.
“[He] has so much energy and wants to play with me and be physically active and I just can’t,” she said. “And I feel like a horrible mother. The depression is unreal,” she said.
“I thought after this accident, ‘Oh, maybe like a year, I’ll be back to normal.’ It just didn’t pan out that way. And now that I think about, like, my son growing up. I’m just like missing the best years.”
With so many changes to her life, McKay said even if ICBC were to approve the treatment she’s sought, “I’ve lost years of my life that I can’t get back.”
McKay seeks long-term relief
In response to McKay filing a claim after the crash, ICBC provided her with treatment and benefits under Enhanced Care related to soft tissue injuries she sustained.
According to ICBC, McKay has received more than $36,000 in income replacement benefits. ICBC has also funded over $97,000 in activities of daily living benefits to help her with her daily household activities and provided over $15,000 to pay for a part-time caregiver.
McKay said that most of the treatments provided under this service, such as acupuncture, chiropractic, and physiotherapy, do not help her injuries.
“I tried to do physio, but I was so sensitive that the physiotherapist wasn’t even able to do a simple stretch maneuver,” she explained. “I screamed and went into a panic attack from the nerve pain.”
What has worked is “intense” painkillers, antidepressants, and massage therapy, which would give her temporary relief, she said.
After trying treatments like laser, trigger point injections, different medications, “the gamut of everything,” McKay said most things were making her worse, “not better.”
Treatment “all out of pocket” without ICBC
With few other options, McKay’s pain specialist recommended a treatment called ketamine infusion therapy. Ketamine is an anesthetic primarily used in medical or veterinary surgery and has also been used as a treatment for pain and mood symptoms, according to Health Canada.
The Canadian Border Services Agency seized illegal ketamine, often sold in powder form, in 2023. (canada.ca)
However, it also has a reputation as a party drug known as Special K, Vitamin K or Blind due to its dissociative qualities. It also has been sold on the black market for use as a date rape drug.
While it has had a legitimate use in medicine for decades, its use for psychological treatments isn’t yet mainstream, and it’s heavily regulated.
According to the BC Ministry of Health, “The treatment is for a variety of pain conditions. Broadly, ketamine therapy is used for pain conditions with a neuropathic component (pain from injury to the nervous system) and central sensitization.”
Ketamine therapy is offered in BC’s public sector “at limited sites,” the ministry added.
St. Paul’s Hospital (4kclips/Shutterstock)
Providence Health Care, which offers intravenous (IV) ketamine therapy at Vancouver’s St. Paul’s Hospital Complex and Interventional Pain Clinic, explains, “IV ketamine therapy is not a ‘cure’ or a ‘fix’ for chronic neuropathic pain, and it can be another tool to help improve patient function.”
The clinic determines dosing protocols and regimens using guidelines from Regional Anesthesia & Pain Medicine (a publication of the American Society of Regional Anesthesia and Pain Medicine).
While the treatment is covered as an MSP-insured service at St. Paul’s Hospital, McKay said she does not qualify for the treatment at the clinic.
McKay has chosen instead to seek treatment from a private clinic, “but it’s going to cost a minimum of $31,000.” She said this does not include the medication she may also require if she needs the treatment on shorter notice or the treatment’s supplies, further adding to the sky-high costs.
“It’s all out of pocket, unfortunately,” she said.
Considering the specialized nature and long wait times (due to the high demand) to see publicly funded pain physicians, the Ministry of Health explained that some British Columbians like McKay seek treatment from a private clinic.
Additionally, “depending on the condition, ketamine therapy may be recommended if other treatments either failed or were not congruent with the patient’s wishes,” the ministry said.
Frustration grows over bureaucracy and long delays
ICBC/Shutterstock
After McKay asked ICBC to cover the cost of the treatment, the company said that it “sought out a comprehensive medical assessment for Ms. McKay, as well as the expert advice of our clinical healthcare advisors.”
This was because of “various sensitivities associated with this and her condition.”
ICBC told Daily Hive it understands McKay had several medical conditions that required her to seek support from a pain management clinic before the collision, plus she was involved in a subsequent crash in December 2023.
The insurance company said that it knows she was advised by a clinic that was helping her with her pain management before the crash in 2021, and, after the incident, it suggested she seek ketamine injections for her soft tissue injuries. Yet, ICBC explained, “We can only fund treatments that medical evidence suggests will help customers recover from their collision-related injuries.”
ICBC provided the recommendations from McKay’s Clinical Medical Assessment (CMA), which “indicates numerous steps to follow prior to reaching a decision of approving ketamine infusion to rule out medical and neurological causes for her symptoms.”
“The CMA has been shared with Ms. McKay and her general practitioner (GP), and we’re awaiting an update from her [general practitioner] GP to complete the recommendations before we finalize our funding decision,” ICBC said.
McKay told Daily Hive that ICBC has suggested her injuries were pre-existing, “which is bullsh**, in my opinion.”
She said the long decision-making process from ICBC has put a strain on her life, adding, “I am getting worse, and they know… because I’ve told them.”
McKay believes ICBC’s duty under Enhanced Care is to pay for treatments that “bring you back to where you were before the car accident.”
“But it’s not working,” she suggested.
Due to the back and forth between McKay and ICBC, she said it’s driven her husband to fundraise for the treatment with a goal of $35,000 to fund “medical infusion therapy to overcome fibromyalgia/chronic pain caused by a bad car accident. Help her get back to being a great mother, wife and teacher!”
McKay said she wants to fight the insurance company in court. However, she can not appeal a decision with the Civil Rights Tribunal until ICBC gives her a letter denying her claim and refusing her treatment.
“The reason why it’s been two and a half years is because I’ve been doing ICBC’s dance for that long to get an answer,” she said. “My file has been pushed to the backburner [and] we’re kind of stuck in this limbo.”