Traumatic Brain Injury Claims in Pennsylvania: Proving What Does Not Show

The scan problem

Emergency imaging is designed to find bleeds and fractures that need immediate intervention. It is very good at that. It is not designed to detect diffuse axonal injury, which is the microscopic shearing that produces much of the lasting difficulty in mild and moderate TBI.

So a person can be told the scan is clear, be discharged, and spend the next two years unable to hold a conversation in a busy room, unable to work a full day, and unable to explain why.

Insurers use the normal scan constantly. It is not the answer it appears to be.

What actually proves it

• Neuropsychological testing. A battery of standardised tests measuring memory, processing speed, attention and executive function, with validity measures built in to address the suggestion of exaggeration.
• Before and after accounts. Family, colleagues and friends describing concrete changes. Not “he seems different” but “he was a foreman running four crews and he now cannot follow a two step instruction.”
• Employment records. Performance changes, errors, reduced hours, termination.
• Advanced imaging in some cases, where it is available and appropriate.
• Contemporaneous documentation of symptoms in the weeks after, which is why reporting cognitive symptoms early matters enormously.

Report cognitive symptoms early

People report the broken wrist and not the fact that they cannot remember conversations. Emergency and follow up records that mention only orthopaedic injury are then used to argue the brain injury was invented later.

Say it. Headaches, light and noise sensitivity, memory difficulty, irritability, sleep disruption, word finding problems, fatigue. Even if they seem minor next to a fracture.

Loss of consciousness is not required

A common misconception, including among some clinicians. Brain injury occurs without any loss of consciousness, and its absence in the record is not evidence against a TBI.

The relationships

Personality change, irritability and loss of initiative are frequently the most damaging consequences and the least documented. They cost people marriages and jobs, and they belong in the claim. A spouse’s loss of consortium claim is a recognized part of Pennsylvania law and it is often the truest measure of what happened.