Yes, You Can Have a Concussion Even Though Your MRI or CT Scan is Negative: How to Show You Suffered a Mild Traumatic Brain Injury (TBI) that Affects Your Life and Ability to Work When Diagnostic Tests are Normal

 

Today’s Conventional Diagnostic Imaging Tests are Not Sensitive Enough to Detect Mild Brain Injury and Concussions. I Discuss How to Win Your TBI Case When the Injury is Invisible to Others.

 

Cases involving traumatic brain injury are some of the most difficult car accident, Social Security Disability, and workers compensation cases to win. 

 

This is especially true for victims of mild traumatic brain injury (mTBI), more commonly known as a concussion. And if you are reading this then there is a high probability you were diagnosed with a mild TBI. The majority of all brain injuries are classified as mild. 

 

Having represented hundreds of brain injury victims across the state, I know that one of the most common defenses to TBI and concussion claims is that there is no visual or objective evidence of injury. Insurance carriers, defense attorneys, and defense medical experts use this lack of objective evidence to portray TBI victims as malingerers, whom are faking and exaggerating their symptoms to get more money. 

 

The purpose of this article is to discuss how to overcome this defense and to get fair compensation for your brain injury when you did not suffer a visible injury to your head, the diagnostic imaging does not show an injury, and you may look fine to others, but your cognitive and social skills have declined. 

 

I hope you find this article helpful. If you have any questions or comments, call me: (804) 251-1620 or (757) 810-5614.  As a personal injury lawyer and workers comp attorney, I represent brain injury victims and their families throughout Virginia.

 

Mild Traumatic Brain Injury – The Invisible Injury

 

There is a phrase that many people say: “Seeing is believing.” It means that you need to see something before you accept that it is real or that it happened.

 

That belief, held by some insurance claims adjusters, defense attorneys, judges, and members of the jury, is what mild traumatic brain injury victims must overcome.

 

In other types of cases it is easy to see the injury with the naked eye. For example, you can see scarring from a burn injury or from surgery to fix a fracture. You can also see the effects of an amputation injury that causes someone to lose a body part.

 

Many of you whom are suffering from a mild brain injury cannot rely on visual evidence the way other types of personal injury victims can. That is because a seemingly minor accident that does not cause you to strike your head or to lose consciousness can still result in a traumatic brain injury and post-concussion syndrome with devastating lifelong consequences.

 

For example, you may slip on ice and hit your head. Or sustain a whiplash injury in a rear-end motor vehicle accident that results in a concussion even though your head did not strike your seat, the dash, or the windshield. These are very real accidents that result in very real problems, but they do not have the same emotional and persuasive impact on insurance companies and juries that more visible injuries do.

 

The Role of Diagnostic Tests in Brain Injury Cases: Did I Have a Concussion if My CT or MRI Results are Normal?

 

You may be thinking: “What about diagnostic imaging tests? Can’t they show that I suffered a brain injury?”

 

For those of you whom suffered a concussion, the answer, unfortunately, is rarely.

 

Diagnostic imaging tests can show orthopedic injuries that are not visible to the naked eye. For example, diagnostic imaging tests are used to show a stress fracture, a herniated disc resulting in spinal stenosis, a torn ACL, the aggravation of degenerative disc disease, or a torn rotator cuff that is not visible with just a glance.

 

Similarly, medical providers use a variety of diagnostic tests to assess brain injury. These include:

 

  • Angiography

 

  • Cervical Spine X-Rays

 

  • Chest X-Rays

 

  • Computerized Tomography Scanning (CT)

 

  • Electroencephalogram (EEG)

 

  • Evoked Potentials (EP) Test

 

  • Magnetic Resonance Angiography (MRA)

 

  • Magnetic Resonance Imaging (MRI)

 

  • Positron Emission Tomography Scanning (PET)

 

  • Single Photon Emission Computed Tomography (SPECT)

 

  • Skull X-Rays

 

Because of how effective conventional diagnostic testing is in detecting other types of personal injuries and medical conditions, there is a common belief that if a person has suffered a traumatic brain injury, then today’s diagnostic tests will detect that brain injury. Otherwise, there is no brain injury.

 

But this belief, held not only by many in the general public but also some practicing physicians, is wrong.

 

Many people with head trauma will have normal results from conventional diagnostic tests like X-Rays, CT scans, MRIs, and EEGs. They may even have normal results with newer, but less common diagnostic imaging techniques.

 

As stated by Dr. M.P. Alexander in his article Mild Traumatic Brain Injury: Pathophysiology, Natural History and Clinical Management, 45 Neurology 1253, 1253 (1995): “By common clinical agreement, neuroimaging studies are negative” for many mild traumatic brain injury patients. This view is supported by other experts in traumatic brain injury and treatment, whom have stated that many patients with a history of brain injury will have evidence of functional impairment even though their MRIs and CT scans may not show abnormalities.

 

Recent studies have concluded that CT scans and MRIs cannot rule out mild traumatic brain injury because they often lack the sensitivity to identify damage to the brain. Some of these researchers and other medical experts have gone one step further and indicated that diagnostic imaging tests for brain injury patients are only indicated when there is loss of consciousness, a penetrating injury, an abnormal Glasgow Coma Scale (GCS) score, or a suspected skull fracture.

 

Fortunately medical researchers are developing more sensitive tests to fight this problem. But in the meantime TBI victims and their lawyers must push back against the myth that a negative MRI or CT scan means no brain injury.

 

Keys to Overcoming the Invisible Injury and Negative Imaging Results in Mild Traumatic Brain Injury Litigation: Objectifying TBI Through Education, Awareness, and Comparison of Your Pre- and Post Injury Abilities

 

When you appear fine physically and cannot show an insurance adjuster, defense attorney, or juror a photograph or diagnostic image to prove you suffered a mild traumatic brain injury, you must rely on other evidence to show that you are struggling post-accident. This is necessary to overcome years insurance company propaganda meant to convince Americans that many plaintiffs are greedy people bringing false or exaggerated claims.

 

Often this requires strong opening and closing statements at trial, and a team of witnesses whose testimony and reports “objectify” your brain injury as best as possible.

 

When preparing your mild TBI case, you should focus on the following to increase the settlement offer or to get a favorable verdict when the objective imaging is not helpful:

 

  • Likeability: Fair or not, whether you are a likeable person is an important factor in winning your TBI case or persuading the insurance company to offer a fair settlement. If you are likeable, the jury will look for reasons to award you monetary damages. Insurance companies know this and adjust their settlement offers based on whether they think a judge or jury will like you.

 

  • Credibility: Even when the defendant’s negligence is undisputed or the insurance company concedes you suffered a compensable head injury under the Workers Compensation Act, the insurance company may dispute the amount of damages or workers compensation benefits you should receive. The insurer may point out that you “look normal” and argue that your complaints about decreased cognitive functioning, headaches, or memory loss are fake or exaggerated. It may even allege that your current symptoms are the result of mental health problems that existed before the accident at the center of your case, especially if you have a documented history of anxiety, depression, or PTSD. You can fight back against these allegations with before and after witnesses, expert medical witnesses, your testimony, and school and employment records that show you were functioning normally before the TBI, but now have serious problems.

 

  • Educating: Your medical experts should educate the jury on:

 

    • How you suffered a traumatic brain injury. This is especially important if you did not strike your head in the accident.
    • How TBI is diagnosed and the limits of conventional diagnostic imaging tests in showing that a person suffered a concussion.
    • Common symptoms of TBI. Your testimony, the testimony of other witnesses, and your medical records and reports should show that you have suffered these symptoms since the initial accident.
    • The short – and long-term consequences of mild traumatic brain injury, both at home and at work.
    • What you are capable of doing with your current symptoms. For example, you may be able to function normally, but only for short periods with lots of rest in between. Or you may be able to work regular hours in a highly structured and routine environment with limited social interaction. Your doctor needs to explain why this is.
    • What your recovery will look like and what future medical treatment you may need. Make sure the costs of this expected care is explained in your settlement demand letter and to the jury.

 

Read my article on medical providers involved in traumatic brain injury cases for more information on how to select the right experts to teach the jury about the seriousness of your TBI and how it affects you.

 

  • Before and After Witnesses: A “before and after” witness is a person who knew you before the brain injury and after the brain injury. This person, usually a family member (spouse or child), close friend, co-workers, boss, family physician, or clergy member, can testify to changes in your personality, temperament, mood, memory, and ability to socialize, go out in public, sleep, concentrate, pay attention, and complete activities of daily living. Just make sure your witnesses are credible or this will reflect poorly on you and your case.

 

Your attorney may even use a day in the life video during mediation or trial to show your struggle more effectively than your trial testimony may do.

 

Get Help from an Experienced TBI Lawyer When the Diagnostic Tests Don’t Help

 

Many people are unable to recognize when a friend, family member, or acquaintance is struggling with a traumatic brain injury. So it is no surprise that insurance adjusters and jurors are sometimes hesitant to pay or to award a fair amount for your traumatic brain injury caused by someone else’s negligence or a work accident when they cannot see direct evidence of the injury itself.

 

But with the help of an experienced brain injury attorney, a team of expert witnesses, and before and after witnesses who know you best, you can overcome this hesitation and win your claim. Even when the MRI and CT scan are normal.

 

Call now for help: (804) 251-1620 or (757) 810-5614.

 

Corey Pollard
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