A traumatic brain injury (TBI) is a life-altering and costly event. Those who have had severe or repeated traumatic brain injuries may have long-lasting problems with movement, learning, or speaking, which require full initial and ongoing assessment and care. Due to the expense of obtaining assessment, evaluation, and ongoing treatment of these cases, high-dollar verdicts in traumatic brain injury (TBI) cases can reach the six- and seven-figure level.
Making the Case for TBI Reimbursement
To prepare for negotiation with defendants and insurers in court or at settlement, a plaintiff’s lawyer receiving a TBI case must produce a Cost of Future Care report, also called a Future Care Assessment or a Life Care Plan to determine the limitations and losses of the client-patient. The Cost of Future Care report considers the severity of the TBI which has been established through assessment tests, and legal reports, medical opinions and technical accident details. To produce a long term needs analysis, the lawyer then researches and consults with relevant experts regarding the client’s prognosis.
Screening and Assessment to Determine Extent of TBI Injury
A doctor initially examining a TBI patient will ask questions to test the patient’s ability to pay attention, learn, remember and solve problems, and will check the patient’s reflexes, strength, balance, coordination and sensation. The doctor may also order imaging tests, such as a CT scan or an MRI to visually assess damage. Periodic, ongoing assessment for months or longer of those with a TBI is important to monitor responses to rehabilitation and to life after the injury.
Once a diagnosis of traumatic brain injury has been established, further screening assessments are performed to evaluate the extent of damage and assist in establishing a comprehensive treatment plan. Screening is conducted by a speech-language pathologist, audiologist, or other professionals.
A speech-language pathologist tests a TBI patient’s speech, language, communication, and swallowing. The speech-language pathologist may also perform a hearing screening. If the patient shows hearing loss, an audiologist may be added to the screening team to further assess hearing loss.
Since depression can be a consequence of neurological damage or part of post-traumatic stress disorder, which often accompanies a TBI, if signs and symptoms of depression are present or suspected, the patient is referred to a neuropsychologist, clinical psychologist, or psychiatrist for further assessment.
Determining Initial and Ongoing Future Care for TBI
Treatment and rehabilitation of a traumatic brain injury (TBI) is often on a long-term basis for months, years, or even a lifetime, and includes:
- Physical and occupational therapy to help a patient regain the ability to do daily activities and live as independently as possible
- Speech and language therapy to help the patient understand and produce language and organize daily tasks and develop problem-solving skills
- Counseling to help the patient understand and cope with feelings and manage activities of daily living
- Social support and support groups for assistance and to share similar experiences with TBI
- Medicines to help relieve physical, mental and emotional symptoms associated with TBI
According to a 1998 report by the National Institutes of Health (NIH), there are 5 million new head injuries in the United States each year. Of that number 2 million sustain brain injuries that result in lifelong difficulties in areas or work, school and family requiring on-going care and support. Most of those individuals (1.9 million) do not require hospital stay, yet they suffer impairments that forever change their lives. About 100,000 of the most severely injured never return to their pre-injury lifestyles, and a large number of them spiral down into poverty and despair.
The extent of initial and on-going costly assessment and care for these individuals, therefore, requires financial means to pay for these expenses. A full assessment of injuries, needed care, and impact on the life of a traumatic brain injury patient is therefore essential. A plaintiff’s lawyer will gather that information to make a case for full reimbursement to pay for all related expenses.
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