TBI’s are easier to prove with better sophisticated imaging test and functional brain imaging studies. From the wars in Iraq and Afghanistan, more people are touched with these TBI injuries.

Generally these cases are categorized as “mild” or involving a loss of consciousness of less than 30 minutes. Most of the time the patient receives a direct blow to the head.

The countercoup injuries are common in MVA cases. The are hard to prove, but if within hours or days following the trauma, the patient develops a secondary brain trauma from a fluid buildup within the skull, decreased oxygen supply or reduced blood flow; the injury can be devastating.

TBI’s are very expensive to prove and often ridiculed by defense. The protocols I suggest are:

1. If you suspect a head blow or your patient was LOC – explore his post accident history -- focus on short term memory & quality of the headaches—dizziness, balance etc.
2. Have patient take a “concussion” test. You can order one from johntawlian@shawnsteel.com
3. Discuss possible TBI with patient’s spouse. Better source than patient.
4. Refer to a TBI neurologist. Most neuros are clueless in this area. Contact us if you need a referral.
5. The TBI neurologist will then probably order special testing including a two day examination by a neuro-psychologist.
   
   
   Don’t assume that any whiplash can cause a measurable TBI countercoup. Go with the evidence.

Patricia Chandaengerwa, a 28 year old homemaker, slowed for traffic, when she was rear-ended by a Cadillac Escalade. Defendant admitted liability.

Injures claimed were brachial plexus injury, bulging disc, epidural injections, constant headaches and shoulder numbness.

Patricia was driven to the ER by her husband. She felt pain radiating down to her right arm. Her DC referred her to a pain management MD. Patricia claimed use of her right arm is now limited, specifically when cleaning or holding her children.

Def claimed she was owed only $3,200 for her DC and nothing thereafter. That she received “only” soft tissue injuries. Def claimed her shoulder injury and disc bulging were unrelated.

Congratulations to Alan Garcia DC, in Victorville.

Chandaengerwa vs. Licher KC 054 814, LA Superior Ct-Pomona, by Judge Robert Dukes

Verdict : $155,000 vs. Allstate Insurance



Kaitlin Bove a college student driving her VW Jetta was rear-ended by a Chevy Cavalier, causing little damage. She was driven to St Jo’s Medical Center where she was x-rayed. Then she was seen at John Muir Medical Group and diagnosed with c sprain and a calf bruise.

She received some 43 chiropractic visits, for a total of $4,722. She also missed one flute lesson. The defense hired Susan Bromley DC to review her chiro records. Bromley argued why so much care for so small an injury? Bromley opined no more than 8 to 12 visits were needed.

Bove v. Nelson: CV 031 971 San Joaquin Sup Ct: Judge Carter Holly. Verdict $3,000. Less than the DC bills!