One day, a potential client walked into our office. She had just parted ways with her first attorney after the two failed to see eye to eye. The prior attorney had assigned a young associate to the case, who saw a big insurance policy and a disk injury and wanted her to have surgery because he saw dollar signs. She was hurting in other ways and felt like he wasn’t listening to her.
During the first visit, we noticed she sat in the chair furthest from the open window. The light coming in was clearly bothering her eyes. We shut the blinds. She asked for some water to take some Tylenol. As we discussed her case, she would struggle at times to find very simple work. Sometimes she would forget what we were talking about while we were discussing it.
“Have you ever been evaluated for a traumatic brain injury?” We finally asked point-blank.
She had not. It had never occurred to her or the prior attorney.
What is a Mild Traumatic Brain Injury?
A Mild traumatic brain injury or MTBI is an injury to the brain caused by the brain being bounced back and forth inside the skull, causing bruising to the brain. Although healthcare providers describe them as mild due to their non-life-threatening nature, these are recognized by the CDC as potentially serious injuries. It is typically assessed when there is a loss of consciousness for less than 30 seconds, post-traumatic amnesia, a GCS of 13-15, and no evidence of structural damage to the brain on CT or MRI. The lack of objective findings is a large part of the reason that MTBIs often go undiagnosed and untreated.
Lawyers Must Know the Symptoms to Identify It
Personal injury lawyers are not typically medical doctors. Additionally, there are no classes in law school that we take to become traumatic brain injury lawyers. An understanding of brain injuries and their symptoms comes only through experience. Thus, if we are to provide our clients with top-notch service, it is critical that every personal injury lawyer have an understanding of the symptoms and an ability to recognize when our clients may be suffering from injuries they do not understand, such as traumatic brain injury. With all the chaos at the scene of an accident, the EMS on site may not notice the signs or bother to perform a Glasgow coma score evaluation. If their lawyer is the next person they see, identifying the problem early may be entirely up to the personal injury lawyer.
What Are the Signs of a Mild TBI?
The most common signs of a mild TBI (a/k/a concussion) are:
- Nausea
- Dizziness
- Sensitivity to Light (Photophobia)
- Headache
- Fatigue
- Difficulty Concentrating
- Confusion
- Memory Loss
- Sensitivity to Sound
Many people who have an MTBI are unaware of the problem. They may blame their issues on age, migraines, or even assume they are symptoms of another injury, such as a neck injury or back injury.
As injury lawyers, we see many of these symptoms in other clients. They may be nauseated by their medication. They can be fatigued because they cannot sleep comfortably. They can have headaches from clenching their shoulders due to a neck injury. But when we observe symptoms like sensitivity to light or confusion when discussing simple topics, we need to recognize the need to look deeper.
Questions to Ask a Client You Suspect of Mild Traumatic Brain Injury
There are many questions that you can ask a client when trying to differentiate whether the symptoms are normal or signs of a TBI. I find it is helpful to have a spouse or someone who knows them very well present to ask also. The people caring for someone with a traumatic brain injury often notice the subtle changes in their friend more than the friend does. Some questions you might ask include:
- Do you find that light or noise bothers you more now than before the accident?
- Have you always had trouble remembering everyday things or focusing during discussions?
- Have you noticed issues finding common words when forming a sentence?
- Do you recall the moment of impact?
Moment of Impact and TBI
Clients with a TBI are often frustrated because they cannot recall the moment of the initial impact from the accident that produced the injury. They cannot and will not ever remember it. I heard a brain injury expert testify once that there is commonly an inability to recall the moment of impact in mild TBI cases because of the way the brain records information. Imagine the brain recording information like a record player (only recording and not reading the record). If you bump the player and the needle skips, a spot is left blank on the disc. You will never recall the moment of impact after a TBI because your brain stopped recording momentarily due to the disruption. You did not forget this information; you simply never knew it.
Conclusion
After we identified symptoms that suggested to us there was an undiagnosed TBI, we helped our client find doctors well-versed in the diagnosis and treatment of traumatic brain injury. Sure enough, the doctors confirmed our suspicion. Our client had an injury that was far more serious than the bugle that the prior lawyer was completely focused on.
If you want to be the best personal injury lawyer you can be for your clients, you need to have the ability to identify signs of potentially serious undiagnosed injuries. Doing some reading on TTBIs and their symptoms can put you at a head start for providing your client with excellent service. There are also several TBI-focused continuing legal education courses that you can take to help you get up to speed. Your client deserves the best you can give them.
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