A traumatic brain injury (TBI) occurs when a blow to the head causes brain damage. A traumatic brain injury includes anything from mild concussions up to severe brain damage. Treatment can range from rest only to intensive care and emergency surgery. Survivors can face a lifetime of disruptions, physical and mental impairment severe cognitive changes.
Brain injuries are very common causes of disability and death in both adults and children and can be caused by something as mild as a bump or contusion. They can be moderate to severe in nature due to a serious concussion, open wound, a fractured skull bone, or from internal bleeding and damage to the brain. Traumatic brain injuries are among the most severe injuries and are in large part caused by slip and falls, pedestrian accidents, motorcycle accidents, car accidents and trucking accidents. Serious brain injuries may result from anywhere between a simple blow to the head to a penetrating injury to the brain. Frontal and temporal areas of the brain are the main areas involved in serious car accidents – which often cause immediate complaints like:
If you or a loved one has suffered a brain injury caused by someone’s misconduct or negligence, it is important to speak to a Hamilton personal injury lawyer who has expertise dealing with brain injuries so that you can understand your legal rights. You have the right to return a Hamilton personal injury lawyer to pursue financial compensation to help replace your lost wages, as well as compensation for your pain and suffering. The person or company who caused your injury may also be responsible for your future health care needs, lost wages, housekeeping, home maintenance, and attendant care needs, among other things.
You should hire a personal injury lawyer who specializes in brain injuries without any delay – preferably prior to your discharge from the hospital. In our experience as Hamilton brain injury lawyers, victims who suffer brain injuries are normally treated in a hospital setting immediately post-accident. The head injury usually involves treatment by a neurologist; where organic damage is present, it will require treatment by a neurosurgeon. At the outset, an accident victim in addition to normal medical treatment will typically receive an evaluation, both physical and psychological, by a physiatrist (a physician specializing in physical medicine). Post-discharge treatment is usually resumed in a rehabilitation center where the physiatrist supervises treatment. It is imperative that you hire a Hamilton personal injury lawyer with expertise in brain injury law prior to going home, so that he or she can ensure that your insurance funding is put into place and that your home and caregivers are set up prior to you going home. Also, you should always leave it up to your personal injury lawyer, and not the insurance company, to hire your occupational therapist who will work with your personal injury lawyers to ensure the proper providers are hired.
Usually a number of therapies will be involved in rehabilitation – and these providers need to be hired by your occupational therapists early in the case. This includes working with a physical therapist, an occupational therapist, a visual therapist, and/or a specialist in cognitive remediation. These stays are lengthy and painful. It is at this stage that the brain injured victim or their family usually seeks the help of a personal injury lawyer or a good legal team. In almost every case, family members or relatives are overwhelmed when they envision the costs of caring for the injured victim, particularly when it appears to be a life-long or long-term disability. This triggers an awareness of the immensity of financial problems facing the victim and/or the family over the rest of their life expectancy.
Our firm offers free consultations, with no obligation. If you’ve suffered a severe a traumatic brain injury, call our Hamilton personal injury lawyers today, no matter where you are in Ontario at 1-844-LALANDE or in the local Hamilton / GTA at 905-333-8888. Our legal team is ready to serve you. Our personal injury accident lawyers have represented victims who have suffered traumatic brain injuries as a result of pedestrian accidents, car accidents, trucking accidents, motor vehicle accidents, motorcycle accidents and in slip and fall cases. In addition, we have represented victims who have suffered spinal cord injuries, and brain injuries, together. It is not uncommon for spinal cord injury victim to have suffered a traumatic brain injury due to the severity of his or her accident.
As Hamilton personal injury lawyers, we must first address the fact that a major head injury case is going to call for a set of special experts in a narrow field of diagnosis and treatment for this devastating injury. Remember, most often treatment and care is totally dependent upon the amount of money which is made available to the victim, and it is up to the personal injury lawyer to ensure recovery of every cent available to you and your family. Getting you the compensation you deserve is our number one priority.
The first step is hiring a qualified occupational therapist who will be on YOUR side and NOT the insurance company’s side. Occupational therapists are key rehabilitation professionals who assist brain injury victims reintegrate back into the community. Their education and training make them experts at evaluation and analysis of an individual’s performance abilities relative to the demands of the activity. Normally, your occupational therapist and your Hamilton personal injury lawyers will ensure that the proper team of physical therapist, speech-language pathologists, neuropsychologists, social workers, and other professionals as appropriate, vocational rehabilitation counselors. It is important that you hire your personal injury lawyers early int he case so that they can retain the appropriate occupational therapists to work with – who will likely remain with you for the remainder of your case, and longer.
The following are some of the different types of head injuries a victim may suffer:
Concussion – a concussion is a mild brain injury to the head that can cause a brief loss of consciousness but does not normally bring about permanent brain injury. A concussion is a diffuse injury, which means it is spread over a large area and cannot be pinpointed to a specific location. Normally a concussion will present as an overall decrease in levels of consciousness.
Contusions – a contusion is when an impact to the head leaves a bruise to a specific area of the brain. This is also known as coup or counter-coup injuries. In coup injuries, the brain is injured directly under the point of impact while in countercoup injuries the brain it is injured on the opposite side of the impact. Contusions are focal injuries – that is to say, the injury is not spread out (diffuse), but it is specific to a location. Focal injuries will have symptoms based on the region of the brain.
Skull fractures – There are 4 major of common skull fractures, including the following:
Intracranial hematomas (ICH) – when a blood vessel in the brain is ruptured, bleeding starts and the blood naturally clots. Sometimes these hematomas are very small. When a hematoma is large, it might compress the brain. Symptoms will depend on the location of the hematoma and hematomas are named for their location. A hematoma that forms between the skull and the dura (the tough outermost membrane enveloping the brain and spinal cord) is named an epidural hematoma. When the hematoma forms between the brain and the dura, it is named a subdural hematoma. When the hematoma forms deep inside the brain, it is named an intracerebral hematoma. Under fortunate circumstances, the body will reabsorb the hematoma. Large clots (hematomas) are periodically removed by surgery.
Some types of intercranial hematomas are:
Diffuse axonal injury (DAI) – axons, which compose what is also known as the white matter of the brain, connect nerve cells throughout the brain. When the brain reverberates (quickly moves back and forth inside the skull), the nerve axons are torn and damaged. During a car accident or when a pedestrian is hit by a car, for example, rapid rotation or deceleration of the brain can cause stretching of these nerve cells on a cellular level, the brain’s normal transmission of signals (information) is disrupted, and this can dramatically impact the person’s alertness and wakefulness.
Ischemia – is another form of diffuse injury. This happens when certain parts of the brain are cut off from an adequate supply of blood. A marked decrease in blood supply is especially perilous for a brain injury victim because the brain becomes extremely sensitive even the smallest decreases in blood supply after a traumatic injury. Changes in blood pressure during the first-week post-head injury can have adverse effects.
Second Impact Syndrome (SIS) – causes the brain to swell catastrophically. SIS is not strictly speaking a type of injury, rather an extreme response of the brain to a second blow to the head/brain (even a very mild blow) after a first impact (seconds up to days after the first blow) already changed the brains functioning and left it in a vulnerable state. A second blow to the head during concussion unleashes a series of metabolic events that might start within 15 seconds. One of the ramifications is a very large increase in blood flow due to a loss of autoregulation of the brain’s blood vessels. Huge increases in intracranial pressure follow, and this might cause cerebellar herniation (the brain is squeezed past structures within the skull) which is very often fatal.
Serious brain injuries can cause problems that are life-changing and incapacitating. The brain is the major control network for the body’s functions and abilities, and it enables conscious communication with our body. It ensures automatic operation of vital organs, the ability to think and reason, and enables functions such as memory, speech, the senses, emotional responses, and more.
Losing even a portion of one of these capabilities can be significant—if not devastating—for the victim and their family members. Brain injuries can cause lifelong medical complications and require an experienced injury lawyer who can assist the victim and family with obtaining the necessary long-term help and care. In some tragic cases, this can also lead to wrongful death.
If your loved one is experiencing such things as difficulty processing information, expressing thoughts, concentrating, making decisions, memory loss, balance issues, headaches, or slurring speech, then he or she should be immediately evaluated for brain damage following a traumatic event such as a car accident, slip and fall, or motorcycle accident.
Proving a brain or head injury to seek the compensation you deserve can be challenging and expensive. In order to ensure that your legal rights are protected, you will need to speak to a Hamilton personal injury lawyer who is experienced in handling the complex legal area of personal injury claims involving head and brain injury trauma. Even if you are unsure about your rights, call us for a free consultation to go over your options.
Below are some of the long term permanent issues suffered by brain injury victims:
After a serious accidents, CT head and MRI scans are normally used to measure changes in anatomical or physiological parameters of TBI. These include hemorrhage, edema, vascular injury, and intracranial pressure. There are different kinds of brain injuries – with the two most common being traumatic and acquired. A traumatic brain injury (TBI) is caused by an external force, such as a hard impact or hit to the head. The impact causes the brain to move inside the skull, which in turn can damage the brain. The Mayo Clinic tells us that with a TBI, a person may experience the following symptoms:
• Loss of consciousness
• Confusion and disorientation
• Fatigue or drowsiness
• Difficulty sleeping
• Sleeping more than usual
• Dizziness or loss of balance
• Word-finding problems and concentration difficulties
• Sensory problems, such as blurred vision and ringing in the ears
• Sensitivity to light or sound
• Memory or concentration problems
• Mood changes or mood swings
• Feeling depressed or anxious
• Confusion, agitation, or unusual behavior
• Change in eating habits
• Persistent crying
• Unusual or easy irritability
• Changes in sleep habits
• Sad or depressed mood
• Loss of interest in favorite toys or activities
If you have suffered a life-changing brain injury, it’s important to speak to a Hamilton personal injury lawyer as soon as possible in order to ensure that your (or your loved one’s) treatment is properly set up and funded after you are discharged from the hospital or brain injury-rehabilitation unit. You may require such assistance as:
Attendant Care and Rehabilitation Therapy – You may require assistance with your day to day activities or re-establishing positive every day routines and transportation on a supervised basis. Rehabilitation therapy can also help suffering individuals relearn skills such as walking, list-making, communicating or self-care. Rehabilitation therapy for a brain injured individual can include different kinds of therapy for cognitive difficulties. Depending on the injury, these treatments may be needed only briefly after the injury, occasionally throughout a person’s life, or permanently.
Psychotherapy – You or your loved one may require ongoing funding for group support, education or long-term support. Not surprisingly, the consequences of a head injury often can also have an affect on the individual’s family members as well. It is not uncommon for family members to need and receive information for the best involvement, counseling and emotional support as well as help with recognition of the family’s needs, adjustment and eventually, a good functional outcome.
Physical Therapy – Often overlooked within a life-care plan, physical therapy is more often than not a necessary requirement for an individual that suffers a traumatic brain injury. An individual with cognitive injury may not appreciate the need for exercise and care for health. Personal support or rehabilitation workers are often necessary since individuals with brain injuries do not make exercise a priority, or they are unable to drive after their injury (thus they have difficulty getting to a gym or place to exercise). Physical limitations also impact the kinds of exercises and types of exercise machines that can be used safely, which can place a victim at risk of injuring themselves while exercising.
Medication – Brain injured individuals may require the monitored intake of medications such as anti-convulsants, analgesics for pain, anti-psychotic (for hostility, nervousness and severe agitation), anti-depressants, anti-anxiety medication, and muscle relaxants or stimulants to increase levels of responsiveness or alertness.
Management of Sleep Dysfunction – Immediately following a traumatic brain injury, the difficulty in falling asleep and frequent waking is very a common occurrence. If chronic sleep disturbances develop, medication or cognitive behavioral therapy focused on sleep may be necessary.
Speech Therapy – Severe accidents may damage portions of the brain that are responsible for language. More often than not, individuals that suffer a severe brain injury can be left with stuttering and word finding issues, making it very difficult or impossible to communicate effectively.
Vocational Therapy – Often, occupational therapists are retained on a temporary or life-long basis to assist with vocational therapy to assist with finding solutions to appropriate job opportunities, help with work place challenges, ergonomic requirements, or with general everyday transportation. Occupational therapists can make a positive difference in a brain individual’s life.
If you or a loved one has suffered a catastrophic brain injury, you may be entitled to substantial compensation, which is subdivided into economic and non-economic claims.
Economic Claims – Also known as special damages, economic claims are calculable and awarded to compensate injured victims for:
i) incurred expenses (i.e. prescription medication, physiotherapy, massage therapy, etc.)
ii) loss of earning capacity and/or income – wage – loss (i.e. early retirement, loss of RSP and/or CPP contributions, loss of competitive advantage, loss of earnings, etc.)
iii) future care costs (i.e. projected expenses for medical treatment, attendant care, housekeeping/home maintenance, etc.)
iv) housekeeping losses, if you no longer have the capacity to care for your home, or you do but at a reduced level.
iv) future management fees (i.e. corporate and/or non-corporate guardians hired to administer a damages award).
Unlike non-economic damages, economic damages do not have a monetary cap or upper limit. Rather, they are assessed by comparing the injured person’s pre-accident versus post-accident circumstances, and providing monetary compensation for post-accident economic losses the injured claimant has sustained and/or incurred.
Non-Economic claims – These are claims such as compensation for damages for pain and suffering, loss of enjoyment of life, loss of amenities, etc. Pain and suffering damages are awarded to compensate a brain injury victim for pain and suffering stemming from his or her injuries sustained as a result of another’s negligent action(s). Non-economic claims, in short, are one’s physical, social, emotional and/or psychological accident-induced impairments which adversely affect one’s enjoyment of life. Pain and suffering awards are not objectively calculable, but rather courts will review your brain injury lawyer’s case that is presented when arriving at an amount to award you. Such factors include, but are not limited to: one’s age, pre-accident versus post-accident lifestyle, degree of the sustained injury and impairment, duration of the sustained injury and impairment, the victim’s function and reliance on others, etc.
The trial of a case involving an individual with a brain injury involves significant and often unique forensic challenges. The challenge to a brain injury lawyer in presenting these cases and obtaining proper compensation for a person that suffered this type of traumatic injury is the misunderstandings concerning the consequences of an acquired brain injury. Not only do victims typically look “normal,” but judges and juries, defense lawyers, and claims adjusters mistakenly believe that there cannot be a permanent brain injury unless there is objective evidence (meaning evidence that you can see) such as a blow to the head, loss of consciousness, and positive imaging on an MRI or CT scan—though none of these commonly-accepted “facts” is true.
In order to successfully overcome these misconceptions, our personal injury lawyers will structure a multi-pronged approach consisting of appropriate experts, lay witnesses, analogies based on jurors’ real-world experiences, and demonstrative evidence is necessary. This may include factors such as:
Establishing that the force was sufficient to cause a significant brain injury: In the case of a traumatic brain injury, in order to establish entitlement to recovery, it is important, and sometimes critical, to establish that the force of the impact to the brain (not necessarily the head) is sufficient to cause a significant brain injury. Many brain and head injury victims often look uninjured, may not have lost consciousness, and have normal imaging studies. A jury must be convinced that the nature and location of the injury claimed by the plaintiff could be the result of the force involved, whether it was caused by a motor vehicle accident or any other type of negligence.
Demonstrating the injury through friends, co-workers, and family testimony: It is vital that testimony from family members, coworkers, and other observers provide examples of how the plaintiff has changed since the injury. Often, family members and close friends provide a strong perspective and case for the impact of the injury and the effects their loved one has experienced since the accident.
Demonstrating the injury through imaging: Often times, a brain injury case presentation is better when the jury can see a “picture” of the injury. There are various forms of imaging, and this field is evolving rapidly. This is typically conducted through CT Scans and MRIs. A traditional CT or MRI of the brain is an image in which images are taken in multiple slices to study the structure of the brain. These images can be presented in many planes of orientation, though most often they are presented as if the brain were sliced perpendicular to the face. There are three keys, however, to understanding the significance of these images:
Thus, in many, if not most cases of traumatic brain injury, the initial imaging studies are abnormal. If there are abnormalities on CT or MRI, so much the better to establish an injury— especially in correlation with impact vectors, neuropsychologic evaluation, and functional imaging. But if these studies are normal, other accepted techniques may help to demonstrate the injury.
Neuropsychological testing: Neuropsychological testing can reveal the nature and extent of cognitive deficits and the victim’s ability to function. If neuro-psychologic testing results showing impairments to a particular area or global function of the brain can be correlated with the imaging results, the testimony of lay witnesses, and the nature of the force involved, the circle of demonstrating an injury to the brain will be closed.
Other demonstrative evidence: Using visual exhibits makes the case more interesting to a jury and helps them to understand what happened and how it has affected the plaintiff.
A case manager will normally be retained by your personal injury lawyers. A case manager is required in any serious brain injury case. If you’ve been deemed catastrophically impaired, you would then be entitled to case management services to help your recovery and day to day living. Case managers are also typically employed for victims of spinal cord injuries and other catastrophic injuries.
Your personal injury lawyer would be the one hiring your case manager. The case manager helps to assure quality care and cost effectiveness and is an absolute necessity for the proper organization and evaluation of the case. This individual is responsible for coordinating the activities of the victim’s rehabilitation. He or she will also advise the brain injury lawyer as to the treatments and the various options opened to the injured victim, act as a communicator between the lawyer, the client and the health professional, and act as an advocate for the injured victim with respect to the various health care providers. A case manager should be a health care professional, occupational therapist, rehabilitation therapist, a physiatrist, or a nurse trained in head trauma.
Experience has taught us that an occupational therapist who is well trained in the area of head and brain trauma is normally the best to work with. The case manager carries out the day-by-day details, seeing that the rehabilitation program goes smoothly and that the funds from insurance companies are properly allocated and on time. Often times, it is easier for someone in the medical profession than for lawyers to make contact with physicians or of the other health care providers in getting appointments, opinions, advising on progress, coordinating treatment and recommending what improvements could be made all along the way. The case manager is, perhaps most importantly, instrumental in helping the lawyer assemble the damages component of the brian injury victim’s case and the team of professionals that goes with it.
The cost of caring for brain injured patients can become astronomical. What becomes important about the cost, however, is that the quality of care for an individual, and thus the quality of life that person can experience after the traumatic brain injury, is dependent on available financial resources. It is important that you speak to a personal injury lawyer who, in turn, can retain and pay the appropriate life care planner.
Life care plans are the way to present future medical and other expenses related to the catastrophically injured brain injury victim. The purpose of a life care plan is to provide the injured victim with tools, skills, modalities, therapies, rehabilitative opportunities, and whatever else is available to enhance the future life of the individual. The overall goal of any rehabilitation and life care plan is to maximize the brain injury victim’s abilities and enjoyment of daily living activities while decreasing functional dependency. Expenses in achieving that goal range from the future cost of special kitchen utensils to full-time attendant care.
Whatever the case, if the matter proceeds to trial, the various needs of the individual must be explained to a jury so that jurors can visualize why, for example, a brain injured person should need special kitchen utensils or neoprene gloves. Many items, such as neoprene gloves, have a life expectancy of their own and require frequent replacement. These items can number in the hundreds. A formula is used where the cost of each item is multiplied by the number of times the item must be replaced over the remainder of the person’s life. The presentation of such testimony must be easily explained to the lay members of the jury and can be a highlight of the trial.
Matt Lalande is Hamilton personal injury lawyer who has represented victims across Ontario since 2003. We have represented victims with personal injury cases involving severe, catastrophic head trauma and recovered millions of dollars in compensation for injuried parties and families of injured loved ones. Over the years, we have gained substantial knowledge and experience working with victims of severe injuries such as wrongful death, catastrophic injuries to the brain, and spinal cord injury, as well as long-term disability.
If you or your loved one has suffered a serious brain or head injury from a car accident, motorcycle accident, slip and fall, or any other accident caused by someone else’s negligence, book a free consultation with our personal injury lawyers. We never charge up front legal fees, and we are 100% victim-focused. We never represent insurance companies.
Contact us 24/7 by submitting an online inquiry or call us directly at 903-333-8888. Our Hamilton personal injury lawyers are experts in brain injury law, and will be more than happy to discuss your legal options with you at your convenience. Our consuiltations are free, and without any obligation.
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