Traumatic Brain Injury Lawyer: Building the Case Insurers Try to Shrink

What counts as a traumatic brain injury?

The CDC defines a TBI as an injury that affects how the brain works, caused by a bump, blow or jolt to the head or by a penetrating injury. The head does not have to hit anything. A car that stops suddenly can move the brain inside the skull hard enough to stretch and tear nerve fibers.

Doctors sort TBIs into two broad groups:

• Closed head injuries, where the skull stays intact. This includes concussion, diffuse axonal injury and bruising of the brain where it strikes the inside of the skull.
• Penetrating injuries, where an object or bone fragment breaks through the skull. A skull fracture can cause either kind.

Two related injuries are handled the same way in a claim even though the cause differs: bleeding in or around the brain, and anoxic or hypoxic brain injury from a loss of oxygen.

How is TBI severity measured, and why does "mild" mislead?

Emergency teams grade severity with the Glasgow Coma Scale, which scores eye opening, speech and movement from 3 to 15. A score of 13 to 15 is classed as mild, 9 to 12 as moderate and 3 to 8 as severe.

The label describes the first hours, not the outcome. NINDS notes that people with a mild TBI can have symptoms that last for months or longer. In a claim, the word "mild" in the ER chart is often the first thing an adjuster quotes. It says nothing about whether the person can hold a job, follow a conversation or drive a year later. Our mild traumatic brain injury page covers how those cases are built.

Other markers carry more weight than the initial score:

• Loss of consciousness, and for how long. Many real brain injuries involve none.
• Post-traumatic amnesia, the stretch of time after the injury the person cannot remember. Its length is one of the stronger predictors of lasting problems.
• Imaging findings such as bleeding, swelling or small hemorrhages seen on MRI sequences designed to detect them.
• Neuropsychological testing that measures memory, attention, processing speed and executive function against expected levels.

What symptoms point to a brain injury after an accident?

TBI symptoms fall into four groups, and they often surface days or weeks after the accident, once the person tries to return to normal life.

• Thinking and memory: slowed thinking, trouble concentrating, losing track of conversations, forgetting new information.
• Physical: headaches, dizziness, balance problems, nausea, sensitivity to light or noise, blurred vision.
• Emotional: irritability, anxiety, low mood, emotional reactions that feel out of proportion.
• Sleep: sleeping far more or far less than before, or trouble falling asleep.

Get emergency care right away for danger signs the CDC lists, including a headache that gets worse and does not go away, repeated vomiting, slurred speech, weakness or numbness, seizures, one pupil larger than the other, or someone who cannot be woken.

Family members usually notice changes first. A spouse who says "he is not the same person" is describing evidence, and we treat it that way. Late symptoms are especially common with closed head injuries, where nothing looks wrong from the outside.

Why do insurance companies dispute brain injury claims?

Because much of the injury cannot be seen. Insurers and defense lawyers rely on a small set of arguments, and a brain injury case has to be built to answer each one from the start.

• "The CT scan was normal." CT is designed to find bleeding and fractures that need surgery. It is not designed to show the microscopic nerve damage behind most concussion and diffuse axonal injury symptoms.
• "There was no loss of consciousness." Losing consciousness is not required for a brain injury.
• "The symptoms came from something else." Depression, prior headaches, age or stress are offered as the real cause.
• "There was a gap in treatment." Weeks without a doctor visit get framed as proof of recovery, when the person often did not know the symptoms were connected.
• The defense medical exam. A doctor hired by the insurer examines the person once and reports that they are fine.

Proving a brain injury goes through the evidence that answers each of these.

What evidence proves a traumatic brain injury?

A strong TBI case lines up medical findings, testing and the account of people who knew the person before and after. No single item carries the case.

1. The first records: the police report, EMS run sheet, ER notes, Glasgow Coma Scale scores and any note of confusion or repeated questions.
2. Follow-up care: neurology, physiatry, vestibular and vision therapy, speech-language therapy and primary care notes that track symptoms over time.
3. Neuropsychological evaluation: standardized testing that measures deficits, including checks for effort that answer the claim that the person is exaggerating.
4. Advanced imaging where appropriate: MRI sequences such as susceptibility-weighted imaging, and in some cases diffusion tensor imaging, read by a neuroradiologist.
5. Before-and-after witnesses: family, coworkers and friends who can describe specific changes.
6. Work records: performance reviews, missed days and job changes that show the effect on earning ability.

What compensation can a brain injury claim include in Maryland?

A Maryland brain injury claim can seek economic losses, such as medical costs and lost income, and non-economic losses, such as pain, suffering and loss of enjoyment of life.

• Past and future medical care, including rehabilitation, therapy, medication and assistive care.
• Lost wages and lost earning capacity when the injury limits the work the person can do in the future.
• A life care plan that prices the care a serious brain injury will need over a lifetime.
• Non-economic damages, which Maryland caps by statute. The cap amount rises each year, so the figure that applies depends on when the claim arose.

Every case has its own value. Brain injury damages explains each category, and brain injury settlements explains what moves a case value up or down. This site publishes no average settlement figures, because an average says nothing about a specific injury.

Which Maryland laws affect a traumatic brain injury claim?

Three rules shape almost every Maryland brain injury case: the filing deadline, contributory negligence and the non-economic damages cap.

• Filing deadline: most Maryland personal injury lawsuits must be filed within three years of the injury. Claims involving children, government bodies and medical care follow different rules, and some require written notice much sooner.
• Contributory negligence: Maryland is one of the few states where a person found even slightly at fault for their own injury can be barred from recovering. Fault evidence gets built early for that reason.
• Damages cap: Maryland limits non-economic damages in personal injury cases, and applies a separate cap in medical negligence cases.

The full breakdown is on Maryland brain injury law. Deadlines depend on facts, so talk to a lawyer about your dates rather than relying on a general rule.

Which accidents cause traumatic brain injuries?

Falls and motor vehicle crashes cause a large share of TBIs. Aaron handles brain injury claims from:

• Car accidents and truck accidents
• Motorcycle crashes
• Pedestrians and cyclists hit by vehicles
• Uber and Lyft crashes
• Falls on unsafe property and injuries at work
• Assaults at poorly secured properties
• Medical errors and injuries at birth

How does Aaron Blank handle a brain injury case?

A brain injury case starts by preserving what fades first: crash evidence, witness memories and the early medical picture. It then follows the medicine, because the full extent of a TBI is often not known for months.

Aaron works from the Blank Kim Injury Law office at 8455 Colesville Road in Silver Spring and takes brain injury cases across Maryland. How brain injury cases work walks through each stage, and about Aaron Blank covers his background.