Traumatic Brain Injury
What is a Traumatic Brain Injury (TBI)?
According to the CDC, a Traumatic Brain Injury (TBI) is an injury that changes the way the brain normally works and can be caused by “a bump, blow, or jolt to the head or a penetrating head injury.” A concussion is one example of a TBI
TBIs may range from mild to severe. Brain injuries are scored using the Glascow Coma Scale which measures eye opening, motor responses, and verbal response. A person will score between 3 to 15 on this scale. When a mild traumatic brain injury happens (score of 13-15), a person may feel dazed or confused or may involve a temporary loss of consciousness and brain tests may even look normal. A moderate TBI (score of 9 to 12) involves loss of consciousness for a few minutes to a few hours. A severe TBI (score of 8 or less) often involves crushing or a penetration of the brain which results in damage to the brain.
TBIs could involve a serious life-changing injury or lead to a wrongful death. Your TBI could involve a case involving a motor vehicle crash, a workplace injury, a medical error, or premise liability.
Key Facts About TBIs
- Falls are the leading cause of TBIs.
- Motor vehicle crashes are the leading cause of TBI deaths.
- Falls, motor vehicle crashes, and assault contribute to at least 9 out of 10 TBIs.
How Common is Traumatic Brain Injury in the United States?
It is estimated that each year 1.7 million Americans have a TBI. Among this group, there are over 50,000 deaths, 275,000 hospitalizations and 1.365 million visits to the emergency room. Fortunately, 3 out of 4 of these TBIs are mild. Falls are the leading cause of TBIs and could be caused by a workplace injury or involve a premise liability case. Motor vehicle crashes are the leading cause of TBI deaths. The rates of TBIs are higher among males than females.
What Causes a TBI?
The causes of a Traumatic Brain Injury vary by age group. Among children ages 0-4 years and adults ages 45 and older, falls are the most common mechanism of injury. However, among people ages 15-44, other causes such as motor vehicle and traffic accidents, assault, and being struck by or against an object or person are common. (Source: CDC, Injury Prevention & Control: Traumatic Brain Injury & Concussion.
Traumatic Brain Injury Facts for New York State:
Among New York State Residents in 2012, there were 118,992 emergency room visits, 19,560 hospitalizations, and 2,306 deaths due to a Traumatic Brain Injury.
Traumatic brain injuries are costly for New Yorkers. From 2010-2012, it is estimated that the average cost of an emergency room (ER) visit for a TBI was $2,551. Further, persons who were hospitalized with a TBI spent an average of 6 days in the hospital, where the average cost of a hospitalization was $46,274. New York State estimates that annually, the total costs for ER visits and hospitals were $308 million and $2.69 billion, respectively. These costs relate to the initial treatment of a TBI and do not include the costs associated with follow-up care and rehabilitation.
SPARCS December 2013
Vital Statistics Death File February 2014
Fact: Falls, Motor Vehicle Crashes, and Assault Contribute to at Least 9 out of 10 TBIs
6 Leading Causes of a TBI for All Age Groups in 2010-2012
- Falls (57%)
- Occupant of a motor vehicle crash (12%)
- Assault (10%)
- Pedestrian in a motor vehicle crash (6%)
- Being struck by or against and object (3%)
- Motorcyclist (2%)
SPARCS December 2013
Vital Statistics Death File February 2014
How do TBIs impact the injured person, their families and the community?
TBIs can result in a variety of health effects and impact a number of areas of a person’s life. They can change the way a person thinks, behaves, moves, speaks and sense the world. Cognitive changes include changes in attention, learning and memory, language and communication, reaction time, or reasoning and judgment. Behavioral and emotional changes could include agitation, confusion, social inappropriateness, or mood changes. Persons who experience motor changes may have a change in balance or trouble walking. Sensitivity to light and vision and hearing changes are common sensory effects. Other general signs and symptoms can include headache, changes in sleep patterns, dizziness, fatigue, or pain.
(Source: CDC. (2015). Report to Congress: Traumatic Brain Injury in the United States: Epidemiology & Rehabilitation. National Center for Injury Prevention and Control; Division of Unintentional Injury Prevention. Atlanta, GA.)
Rehabilitation is important to improve function in persons who sustain a TBI, and this can take place in a variety of settings. Cognitive rehabilitation can help people to learn skills to make up for their cognitive limitations. Physical rehabilitation could include massage, exercises, and special equipment to improve walking or balance, or medications to address involuntary muscle contractions. Vocational rehabilitation services can help an individual with job training or job placement.
A TBI impacts more than just the injured; the family is also changed. With a severe TBI, family members often become the caregivers and this sometimes requires someone to give up their job or make changes to their work schedule so they can tend to the needs of their spouse, child, or other loved one. Relationships often change as a result of the physical, psychological, emotional, and financial stressors that accompany a TBI.
When a person is injured and suffers a TBI, the community is also affected. Neighbors lose the lawn and gardens that were once the most well-kept and beautiful on the street. A soccer team loses a dedicated coach that volunteered his time every season. A church choir loses a familiar voice because the singer cannot read or remember the words to the hymn. A community group loses a volunteer because the person that was hurt no longer can stand to be around lots of activity or noise. A company loses their most charismatic businessman/woman because people who suffer a brain injury often can no longer work. They can’t concentrate, they get headaches from lights and they can’t process conversations fast enough and grow frustrated. I remember a case I handled where the dying lost one of the most caring and attentive hospice nurses because her brain injury made it so she could no longer remember how to drive a car or what to do once she got to her patients’ homes. Brain injuries steal so much from the injured party and always leave a hole in the community. It is like a death where the injured person is left in limbo. They look physically fit, but their old life is profoundly changed.
Kuehner Law Firm Approach
Life Care Costs
Loss of Earning Capacity
Pain and Suffering & Loss of Enjoyment of Life
After a TBI, a person may need help with daily activities, regular occupational or physical therapy, or other medical care. While a family member may provide all of some of this care, this care has value and comes as a trade-off from leaving their job or not being able to engage in other activities or retirement. We work with experts that have specialized training and experience. They know exactly what a patient with a TBI will need. We arrange for meetings, interviews and extensive planning by these experts so that we can show an insurance company, judge and jury exactly what is needed to allow patients with brain injury to live a life as close to their previous ability as possible. Often this will involve our clients traveling to major medical centers out of state for meetings, tests and evaluations. These evaluations are state of the art and intended to show not what our clients can do now but rather, what they should be able to do if they are fully compensated for their harms and losses. If travel is impossible, we bring the experts here to meet with and evaluate our clients. With brain injury, lawyers have to handle the cases differently. Our clients often look good. They look unhurt. We need to have specialized evaluations and testing so that we can overcome the fact that they may appear unhurt. These objective tests allow us to show the jury that the injury to our client is as real, and often more devastating, than a broken bone which we could prove with a simple x-ray.
Loss of wages after a TBI can vary depending on whether a person is completely unable to work, requires a reduction in hours worked, or requires changes in the type of work a person is able to perform. A TBI may result in a person being unable to focus or concentrate, can cause a person chronic pain due headaches, and can cause fatigue or memory problems. We work with experts to evaluate our client’s abilities and project the loss of earning capacity based on the nature of their TBI symptoms. These specialists are called vocational rehabilitation experts and we only work with the best who have extensive experience working with people suffering from brain injury. Again, brain injuries are special and needed to be treated differently.
After a TBI, a person may experience a dramatic reduction in their quality of life. This may be due directly to physical injury (e.g. loss of smell, loss of mobility, etc) or it may be due to psychological changes (e.g. anger, depression, etc). These damages can be hidden from a casual observer. Even inexperienced attorneys may not know to ask if a client’s sleep pattern had changed. Is insomnia now a problem. Relationships change dramatically after a brain injury. A wife may not understand why her husband, who has always loved hiking with her, no longer ever wants to go outside. A husband that highly valued the fact that he and his wife used to go to church together every Sunday may not understand why she simply won’t go anymore. These are common examples of how brain injury can affect a family. The Kuehner Law Firm understands these injuries and knows how to show them to insurance companies, judges and juries so that injuries are fairly judged and fully compensated.
Making the Community Safer