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TBI Workers Comp & Personal Injury Cheat Sheet (DRAFT) by [deleted]

Credit to Susan Conley, Esq. SEAK 2013

This is a draft cheat sheet. It is a work in progress and is not finished yet.

1. Define of How Injury Occurred

• Head struck by object.
• Head strikes object.
• Accele­rat­ion­/de­cel­eration movements w/o direct external trauma to head.
• Foreign body penetrated the brain.
• Forces generated from an explosion.

2. Severity of Injury

Range from “mild” (brief change in mental status or consci­ous­ness) to “severe” (extended period of uncons­cio­usness or amnesia after injury).

A. Mild
• LOC < 30 minutes (Loss of Consci­ous­ness)
• AOC or mental state lasting up to 24 hrs (Alter­nation of Consci­ous­ness)
• PTA up to 24 hrs ( Post Traumatic Amnesia)
 ­ ­ GCS (best available score during first 24 hrs) of 13-15; not a predictor of function or rehabi­lit­ative outcome.

B. Moderate
• LOC > 30 Minutes and < 24 hours
• AOC > 24 hours
• PTA > 1 and< 7 days
• GCS = 9-12

C. Severe
• LOC > 24 hours (Loss of Consci­ous­ness)
• AOC > 24 hours
• PTA > 7 days
• GCS = 3-8
Legend: Source DOD/VA Common Definition 2007
LOC – Loss of Consci­ousness
AOC – Altern­ation of Consci­ousness
PTA – Post Traumatic Amnesia
GCS – Glasgow Coma Scale

3. TBI Symptoms

Symptoms typically fall into one of three catego­ries:

A. Physical - Headache, nausea, vomiting, dizziness, blurred vision, sleep distur­bances, weakness, paresi­s/p­legia, sensory loss, spasti­city, aphasia, dysphagia, dysart­hria, apraxia, balance disorder, disorders of coordi­nation or seizure disorder.

B. Cognitive - Problems with attention, concen­tra­tion, memory, speed of proces­sing, new learning, planning, reasoning, judgment, executive control, self-a­war­eness, language or abstract thinking.

C. Behavi­ora­l/E­mot­ional - Depres­sion, anxiety, agitation, irrita­bility, impuls­ivity or aggres­sion.

4. Evaluation for Defense

The following should be obtained:

• Mechan­ism­/Force of Injury
• Prior Medical Records
• Prior mental Health­/Ps­ych­olo­gic­al/­Che­mical Dependency Records
• Educat­ional Records – including all testing ACT, SAT, Guidance, 504 Plans, etc.
• Employment Records
• Social Media Records
• Raw Data Testing Pre/Post Injury
• Witness Interviews for observ­ations of behavior changes pre/post injury
• EMT/Am­bul­anc­e/P­olice Record­s/i­nte­rvi­ew/­obs­erv­ati­ons­/Gl­asgow Scale
• Emergency Room Records
• Neuro psycho­logical testin­g/RAW data
• Consults
IME Consid­era­tion:
o Neurol­ogical
o Neurop­syc­hol­ogical
o Vocati­ona­l/S­pee­ch/­Occ­upa­tional