Injury claims involving a brain injury, where proving an injury that may not show on a scan, and valuing a lifetime of care, are the central legal problems.
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A traumatic brain injury claim is not a separate cause of action. It is a negligence, product liability or other injury claim in which the harm is a brain injury, and the legal work centers on two questions: proving the injury, and valuing it.
Proof is harder than for most injuries. Many concussions and mild brain injuries do not appear on standard CT or MRI imaging, so the case often rests on symptoms recorded soon after the event, neuropsychological testing, and the observations of family and co-workers about changes in memory, concentration, mood or personality. Those opinions come from expert witnesses, and in federal court an expert's testimony is admitted only if the judge finds it more likely than not that it rests on sufficient facts and reliable methods reliably applied (Fed. R. Evid. 702; Daubert v. Merrell Dow Pharmaceuticals, Inc., 509 U.S. 579 (1993)). Many states apply the same test.
Valuing a serious brain injury means projecting future needs: medical and rehabilitative care, attendant care, lost earning capacity, and often a written life care plan prepared by a specialist. Federal programs affect how a recovery is handled. Medicare is a secondary payer and must be repaid for conditional payments it made for injury-related care out of a settlement or judgment (42 U.S.C. § 1395y(b)(2)). For a person who relies on Medicaid, a special needs trust that meets federal requirements can hold the recovery without ending eligibility (42 U.S.C. § 1396p(d)(4)(A)). If the injured person can no longer manage their own affairs, a court may need to appoint a guardian or conservator to approve a settlement.
Tell every treating provider about all symptoms, including headaches, memory problems, sleep changes and irritability, because early records are often the strongest evidence. Keep a short daily record of changes. Speak to a lawyer before settling, since brain injury symptoms can take time to become clear, a release usually ends the claim permanently, and Medicare, Medicaid and guardianship issues need to be resolved as part of any settlement.
Worried about the cost? A lawyer can be hired for one part of a case only (limited-scope representation), may be paid from what a claim recovers (contingency fee), or may be free through a pro bono program or legal aid; a court can also waive its own filing fees.
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