Evaluating Traumatic Brain Injuries

Traumatic Brain Injury (TBI) claims present unique challenges for the Club and its Members because TBI claims often rely on subjective complaints and complex neuropsychological testing. Subjective complaints can be fabricated and neuropsychological testing, which should be objective, can create ambiguity since the results require clinical interpretation and experts – who may be paid for their opinions – can overinterpret the results or take them out of context. What may happen is that seemingly minor incidents can turn into potentially high-exposure claims. Understanding how to evaluate these claims effectively is critical for controlling costs and ensuring fair outcomes. 

1. Why TBI Claims Are High Risk 

• Subjective Nature of Symptoms: Plaintiffs often allege headaches, memory loss, mood changes, and cognitive deficits – symptoms that are impossible to verify objectively. 

• Delayed Onset: Many claims involve symptoms first reported weeks, months, or even years after an incident, which raises questions about authenticity and causation. 

• Juror Sympathy: Brain injuries typically evoke strong emotional responses from jurors, increasing the risk of large verdicts, even in mild or questionable cases. https://www.iadclaw.org/assets/1/19/26.1_-_Burden-_Successful_Strategies_Mild_TBI_Claims.pdf?2939  

2. Initial Evaluation: Accident Details Matter 

Defense of TBI claims begins with a thorough review of: 

• Mechanism of Injury: Minor falls and other low-intensity impact accidents rarely produce serious TBIs. To the extent possible, document the height of falls, and the speed and impact of forces, and take photos and videos.  

• Immediate Reports: Ship’s medical officer or medical facility notes, medevac records, ER records, and witness statements often reveal whether the claimant appeared disoriented or complained of head trauma at the time or immediately after the incident. 

• Consistency: Compare early statements with later allegations for discrepancies.  

3. Medical Records and Prior History 

• Pre-Existing Conditions: Depression, anxiety, migraines, or prior concussions can explain current symptoms. 

• Treatment Patterns: Gaps in medical care or failure to follow recommended therapies may undermine claims of impairment. 

• Objective Evidence: CT and MRI scans often show no abnormalities in mild TBI cases. Defending against TBI can be tricky since the defense should highlight the absence of objective evidence, while avoiding appearing dismissive.  

4. Challenging Neuropsychological Testing 

Plaintiffs frequently rely on neuropsychological testing to establish disability and damages. Neuropsychological testing presents challenges both in its complexity and the potential for misinterpreting the data.  

• Validity Measures: Ensure tests include checks for effort and exaggeration. 

• Alternative Explanations: Stress, litigation, preview of the test, or pre-existing psychological issues can affect test performance. 

• Expert Review: Defendants should retain neuropsychologists familiar with malingering detection and reliability of testing protocols to review and, if necessary, reinterpret test results.  

5. Leveraging Objective Evidence 

• Scene Documentation: Photos, CCTV footage, and immediate response observations are invaluable. 

• Employment and Social Records: Testimony from supervisors, fellow crew members, or other acquaintances about the claimant’s functioning before and after the incident can counter subjective complaints. 

• Biomechanical Analysis: Demonstrating that the forces involved were insufficient to cause brain injury can be persuasive.  

6. Emerging Medical-Legal Issues 

• Advanced Imaging (DTI, fMRI): Plaintiffs increasingly use these techniques to claim subtle brain damage, but not all are generally accepted in the medical community. Defendants should scrutinize the methodology and clinical relevance, and challenge techniques using Daubert motions, when appropriate. 

Blood Biomarkers: While promising, these tests are not yet universally accepted in litigation. Defendants should monitor admissibility trends. 

7. Settlement and Trial Strategy 

• Early Case Assessment: Identify weaknesses in causation and credibility early to guide negotiations. 

• Avoid Over-Aggression: Suggesting fabrication can backfire with juries. Focus on inconsistencies and objective evidence. 

• Expert Collaboration: Work closely with neurologists, neuropsychologists, and accident reconstruction specialists to build a science-based defense.  

Conclusion 

Defending TBI claims requires balancing skepticism with sensitivity. By emphasizing objective evidence, challenging questionable methodologies, and leveraging expert testimony, defendants can mitigate exposure while maintaining credibility in court. A proactive, evidence-driven approach is the cornerstone of successful TBI defense.