“Mild or Moderate” Brain Injury, The Family, And The Lawyer
For years, medicine has classified TBIs as mild, moderate and severe in relation to the duration of the loss of consciousness following a trauma to the brain. Recently, “severity and length of amnesia” has been used in determining classifications of “mild” and “moderate” brain injury. A person need not lose consciousness in order to sustain a life altering TBI. As personal injury lawyers practicing in Atlanta for approximately 30 years, we have seen hundreds of automobile and other traumatic injury victims. Most of these car accident and general trauma victims did not receive traumatic brain injuries. However, many did suffer a TBI and had no knowledge of it. In fact, the treating physician probably did not prescribe “treatment” for the TBI patient, but rather, invoked the “wait and see” methodology and gave a diagnosis of “post-concussion syndrome”. The doctor, client, and attorney can all see the contusions or broken bones, but what does “post-concussion syndrome” (PCS) look like? (See Glossary). Even though a CAT scan, MRI, or EEG study may have been conducted. These devices are fine for detection of hematomas, hemorrhages or seizures while they are occurring. However, they will not detect microscopic damage to brain tissue. Usually, several weeks, if not many months after the traumatic automobile accident or traumatic event, the personal injury lawyer acquires the medical records from the emergency room. The number of ER medical records that contain the diagnosis “post-concussion syndrome” is striking.
Often our personal injury attorneys will ask a car accident victim or severe trauma victim to bring his or her spouse or close relative to a meeting at the law office. The personal injury lawyer will ask the spouse “What about this ‘post-concussion syndrome’? Have you noticed any changes in your loved one’s cognitive functions or emotional and personality disposition since the injury?” The definition of “post-concussion syndrome” though inherently vague, becomes clear and absolutely real. They often answer as if in reality, there is a line in time and space, like the International Date Line, that together their lives have crossed. There is now the terribly real “post-accident” life that they must live, and they fear that they will never return to their “pre-accident” normalcy. They want to just live “like they used to”, but they cannot. The accident or trauma victim now suffers headaches, memory deficits, concentration problems, poor judgment, behavioral and emotional dysfunction, fatigue, anxiety, depression, sexual dysfunction, violent mode swings, and emotional volatility. There are often work problems, loss of employment, discussion of divorce, etc… Personal injury attorneys are not neurologists or neuropsychologists, but it sometimes obvious that automobile accident and trauma victims/clients need such professional medical assistance. This professional care will help the personal injury attorney do his/her job in court, which is, in part, proving the damages of this case, and making a jury understand the life altering devastation caused by this “post-concussion syndrome”.
There is a battery of tests a neuropsychologist can perform to give a medical diagnosis of, and establish the root cause of, this very real and very devastating injury, TBI. The results of these tests help juries see the life altering symptoms a family could only too plainly see in their loved one but could not explain. Cognitive tests include the Halstead-Retan Test Battery including the Wechsler Adult Intelligence Scale Revised (WAIS-R); the Complex Figure Test; the Wisconsin Card Sorting Test and the Category Test. Language skills are measured by the Controlled Oral Word Association Test and the Boston naming Test. Verbal memory is gauged by the Auditory Verbal Learning Test (AVLT). Visuo-motor function by the Bender-Gestalt Test. Emotional disposition is tested by the Minnesota Multiphasic Personality Inventory (MMPI, the Thematic Apperception Test, and the Rorschach Test. The list goes on and on.
The personal injury lawyer has the duty to assist his traumatically brain injured client to acquire just and fair compensation for his visible as well as “less than visible” injuries. Often in the process of assisting the client and his or her family achieve financial remuneration for their losses, the personal injury attorney also helps his client regain control over internal losses as well, which is a benefit to all.
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