Considerations for Evaluation of Traumatic Brain Injury Claims
Whether an incident was a minor motor vehicle accident or slip and fall, you may have a case where the plaintiff is claiming a traumatic brain injury (TBI). Is it possible for something not-so-traumatic to cause a TBI? Can a mild concussion, or the presence of concussion symptoms, even equate to a traumatic brain injury? It’s possible.
Per the NIH National Institute of Neurological Disorders and Stroke, “a TBI can be caused by a forceful bump, blow, or jolt to the head or body, or from an object that pierces the skull or enters the brain, but not all blows or jolts to the head result in a TBI.”[1] The American Association of Neurological Surgeons defines a TBI as “a disruption in the normal function of the brain.” [2] TBIs are considered mild, moderate, or severe based on the symptoms and mechanism of injury. Symptoms can start immediately or gradually and may be temporary or permanent, depending on the severity.
Symptoms of a mild TBI include physical symptoms like headaches, nausea, vomiting, dizziness, and fatigue; sensory symptoms like sensitivity to light or sound, ringing in the ears, and blurred vision; and cognitive, behavioral, or mental symptoms like loss of consciousness or feeling disoriented, issues with memory or concentration, feelings of depression and anxiety, difficulty sleeping, and mood changes. [3] With moderate or serve TBIs, the mild symptoms will be more produced and may include symptoms like persistent headaches, convulsions or seizures, loss of coordination, pupil dilation, weakness or numbness of fingers and toes, slurred speech, agitation and combativeness. Severe TBIs may even cause one to become comatose for periods of time or lead to brain death. [4]
Often, we are faced with a plaintiff who claims a TBI but only elicits minimal and mild symptoms, the most common being headaches. When evaluating a plaintiff’s injuries and damages, it is imperative to enlist the assistance of a medical expert and use the discovery process to your advantage. Obtain all relevant records pertaining to the plaintiff’s medical treatment and diagnoses following the incident, as well as the plaintiff’s pre-existing history. Evaluate whether the plaintiff sought care from specialists, including neurologists. If the plaintiff was transported from the scene of an incident by ambulance, obtain the EMS records as these can provide information on the plaintiff’s physical and mental status immediately following the incident. Look to see if a Glascow Coma Scale was performed on the plaintiff either by EMS or ER providers. Obtain reports from any diagnostic imaging, especially CT scans of the head. Use depositions to your advantage by asking the plaintiff targeted questions about their symptoms and functional status following the incident. Evaluate whether the plaintiff can recall specific details of the incident and ask about the mechanism of injury to determine whether there was a blow to the head or body. Inquire whether the plaintiff can manage activities of daily living, like bathing or getting dressed, or whether they can drive, read, work, exercise, or participate in their familial routines. Further, ask when symptoms started and evaluate whether there were other stressors that contributed to or caused those symptoms.
Provide all relevant medical records, discovery responses, and deposition transcripts to your neurological medical expert. The medical records along with the plaintiff’s responses to discovery and testimony can help your expert provide a thorough evaluation as to whether the plaintiff sustained a TBI or a mere bump to the head.
[1] Traumatic Brain Injury (TBI) | National Institute of Neurological Disorders and Stroke (nih.gov)
[2] Traumatic Brain Injury – Causes, Symptoms and Treatments (aans.org)
[3] Traumatic brain injury – Symptoms & causes – Mayo Clinic
Written by associate Caitlin Vannoy.