Traumatic brain injury (TBI), spinal, and back injuries each present a number of challenging medical, economic, and legal issues for their victims. From a medical standpoint, these injuries tend to have long lasting and debilitating effects, often requiring long-term care and substantial loss in quality of life. From an economic standpoint, diagnosis and treatment of these injuries can be extremely costly, and lost income is also a serious concern. From the legal perspective, there are challenges associated with proving the extent of the damages and persuading insurers and liable parties to make a fair and adequate settlement offer.
When someone is the victim of a traumatic brain injury, they often require long term medical care. These costs pile up substantially over time. Though more research is needed, studies have shown that long term care costs were in the range of $35,000 for the mildest forms of TBI and care for moderate injuries were in the range of $80,000 (in 1993 dollars). These costs are doubtless higher now.
And this is not even considering the lost quality of life that affects brain injury patients. According to the CDC, victims of TBI suffer problems related to cognitive functions, motor functions, sensation, and emotion. This means a traumatic brain injury can have a devastating and debilitating effect on a person's life and productivity. While difficult to measure in some cases, these are real costs.
The economic costs are closely related to the medical issues. Long term care is costly. And lost productivity due to impaired neurological functioning is also a major opportunity cost. These costs of course are most acutely felt by the victim, but at least one estimate places the total social cost of TBI at $76.5 billion annually. But beyond the numbers, there are the difficult to quantify matters of diminished quality of life (known as hedonic damages), which many economists have argued actually matter and can be valued.
From the legal standpoint, the most challenging aspect of any TBI case is proving damages. Such proof generally requires both expert and lay witness testimony. Lay witnesses called to prove TBI will generally testify to their "before/after" observations as to the effects on the victim's cognitive or motor functions, including diminished memory, sharpness, quickness, and difficulty in performing tasks they once did with ease. Generally these witnesses will be family members and co-workers.
Expert testimony will generally be given by professionals such as neurologists, radiologists, neuropsychologists, occupational therapists, speech therapists, or others, depending on the type of injury and the specific functions affected. Their testimony will focus on empirical data such as medical examinations, neuropsychological testing, brain imaging results, and results of tests designed to gauge cognitive and motor functions.
Brain imaging has improved drastically in recent years, allowing plaintiff's attorneys to provide juries with more illustrative evidence of the lingering effects of trauma. With the development of Positron Emission Tomography (PET scans), attorneys and their expert witnesses can now point to visual indicators of disruptions in brain functionality. Earlier imaging technology such as MRIs and CT scans could only depict structural damage. PET scans, however, can show abnormalities in blood flow and electrical impulses to illustrate impairment of functions that once required lengthy explanations that were difficult for jurors to follow.