Investigating a Traumatic Brain Injury


Whether it is a traumatic brain injury or a car accident, insurance companies and adjusters have a system that allows them to pigeonhole an accident injury. Insurance companies do this to avoid a thorough investigation of an accident case and transpose the initial facts into the bottom line. It is fair to say that most things are not what they appear to be on the surface. Rather, there are layers of facts that provide a real understanding. This is certainly true of accident cases that involve my clients. 

As seasoned accident injury lawyers, we look at our clients as if we were the client ourselves. Would we be satisfied if someone pretended to understand the ins and outs of our case based on the initial interview? The answer to that is a resounding no. Would we want our advocate to spend his or her time investigating the incident and using legal arguments to win the compensation we deserve? Yes! This is the way we think of our clients. Let’s delve into this and see what an attorney should do when faced with a new case involving a traumatic brain injury since many times, the entirety of the symptoms are not easily defined from the get-go.

Where the Traumatic Brain Injury Investigation Begins

Initially, our firm arranges a free case review. During this initial interview, we learn about the accident, how the individual was injured, and review any documentation, they bring with them. Such documentation includes police and medical records and wage reports. Once this introductory phase is completed, we open up the discussion to questions, some from our legal team and others from the injured party. In short, we spend the time getting to know one another and delving into the accident. 

At some point, the injured party may decide to go ahead and retain our firm. There is some paperwork to sign, and the work is about to begin.

Traumatic Brain Injured Clients

Some traumatic brain injuries are clear cut. The client has difficulty with memory and describes a period after the accident, where he or she encounters many changes. For instance, they describe memory loss that is worse in the short term. They can remember things that happened a long time ago but not the accident or events that occurred yesterday. They may also fail to remember that they need to pay a bill, shut the water off, or put out food for their cat. In mild cases, all the deficits might be hidden, and things may even appear normal until you look deeper. 

Emotional Lability

Other problems described by a TBI client include emotional lability. This occurs when they laugh at a serious event and cry, sometimes uncontrollably, during a humorous one. In some cases, this emotional lability occurs without a precipitating event. They may describe being mentally subdued, such as if they were in a mental fog most of the time. 

The client may even mention that he or she had a good relationship with loved ones before an accident, but since then has been angry and argumentative. In addition, their hobbies have fallen by the wayside, and they no longer express interest in them. They describe feelings of listlessness and fatigue, preferring to sleep for days on end. Sexual activity may have fallen off also.

Attempting to Understand Changes

After hearing from the client, we often sit down with their close family members to see how they perceive the changes that are noted. This is an important aspect of our intake, and the family is usually eager to explain what they observed. 

The family members explain that they have been trying to research the subject and find out what they can do for their loved one. This is our opportunity to provide a list of resources that can be used in this regard. Small ways of helping the traumatic brain injured person make sense of their new reality can go a long way. For example, the family can use post-its at home to remind the person to do certain things. This helps them get through the forgetfulness that is often a symptom of TBI and its accompanying anxiety. 

Checking the Medical Records

Some clients are unable to fully describe what happened immediately during and after the accident, if at all. This deficiency is assisted by a complete review of the medical records. From the initial reports by first responders to emergency doctors and nurses, it is all there. Even momentary confusion when the patient is asked their name, date of birth, and other questions with an obvious answer are recorded. If the patient required emergency surgery due to complications that resulted from their injury, it is documented in the reports. 

What Happens If a Complication Was Missed

This occurs from time to time, and a thorough review of the medical records with the help of an expert can determine if complications were missed. An interesting question here is who is responsible. According to California Civil Jury Instruction 3929, the defendant is liable for additional harm from others in attempting to provide medical treatment. That means that if the initial injury was caused by a negligent driver and the injured party was further hurt by the application of medical care, the negligent driver is considered responsible for it all. 

Examination By a Neuropsychologist

Sometimes, the initial MRIs and CT scans failed to identify a traumatic brain injury. In such cases, the use of neuropsychological testing is useful. These tests evaluate a psychological function linked to a particular brain structure or pathway. By administering these tests, it is possible to find brain trauma deficits.

MRI Evaluation

By using MRI studies before and after the administration of gadolinium (contrast), areas of hyperintensity may be found, which indicate traumatic brain injury. Functional MRIs (fMRI) are also useful because of their ability to show brain activity through blood flow. By using this technique, it is possible to show prior traumatic brain injury.

The video below discusses images of traumatic brain injury that are seen through MRI studies.

Investigation of a Possible Brain Injury

An attorney must investigate his or her client’s case to determine the extent of their injuries. Further, it is important to evaluate the disability the injuries will cause in the future. Both criteria are essential in reaching adequate compensation

If this is left undeveloped, the client will face a bleak future trying to pay for continued medical care without receiving funds to do that. If the case is settled without doing this, the insurance company will insist that the injured party sign a waiver. The waiver forbids them from filing a claim due to damages incurred in the same accident in the future. 

It is difficult to reassure a client that it is necessary to wait. That is understandable since the client faces mounting bills often without being able to work. However, facing extended future medical care could financially strap a family.

How an Attorney Can Help After a Brain Injury Accident

At our firm, we immediately send investigators to the site of the accident. Our investigative team makes every effort to determine how a collision happened using accident reconstruction techniques. We interview witnesses and obtain video footage from traffic surveillance cameras and those on nearby businesses that show the incident as it happened. Our investigators also review police reports of the accident, looking for mistakes since these records are frequently used in negotiations with the insurers and in court. 

Once all the evidence at the accident scene is gathered, the investigators release it to our legal team to use it to build a robust case for our client.

Read the following to learn more about traumatic brain injury:

San Francisco Brain Injury Lawyer

I’m Ed Smith, a San Francisco brain injury lawyer. Evaluating accident injuries is an essential part of my practice. No client deserves any less than we would be willing to accept. A lawyer must have an abundance of information when dealing with an insurance company. They may try to simplify your accident, but we know from experience that traumatic injuries are anything but simple. 

If you suffered traumatic brain injuries in an accident, we are available to provide free and friendly advice. You can call us at (415) 805-7284 or toll-free at (800) 404-5400. You can also reach out to me online if that is more convenient for you.

We've helped San Francisco residents with all varieties of car accidents, wrongful deaths, and other traumatic injuries. 

We are members of the Million Dollar Advocates Forum and the National Association of Distinguished Counsel.

See our client reviews on AvvoGoogle, and Yelp, and our past cases on our Verdicts and Settlements page.

Editor’s Note: This page has been updated for accuracy and relevancy [cha 2.10.21]

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