Brain Injury Medical Experts

by Ryan J. Vlasak
Bracamontes & Vlasak, P.C.

The differences between treating physicians and retained experts can be confusing to anyone trying to navigate the complexities of the health care and legal system after sustaining a brain injury. Treating physicians provide immediate medical care to the patient after an injury whereas retained medical experts are hired for purposes of litigation. All reputable plaintiffs’ law firms will take brain injury cases on a contingency basis and will cover all costs, including costs for retaining experts.

While the treating physician’s role is to provide and track the immediate treatment needs of the patient, retained experts should quantify and project the patient’s loss into the future. The lawyer’s role is to retain the best team of experts for the case and to ensure that the client is receiving appropriate and adequate treatment now and that damages are accurately projected at the time of trial to cover future medical costs and financial losses. This often involves using the client’s insurance to pay for the best treatment available and forwarding large sums of money to retain the right team of experts to accurately quantify future treatment needs.

For example, while a treating neurologist may diagnose “post-concussion syndrome” (“PCS”) in the records, if the symptoms persist for over a year, in some cases a diagnosis of “chronic traumatic encephalopathy” (“CTE”) may be more appropriate. Although the symptoms overlap, CTE is a much more significant injury because it can last a lifetime, whereas PCS by definition is expected to resolve. Retained medical experts should opine about the patient’s total loss, not only her medical needs now. By way of another example, full neuropsychological workups are seldom done by providers in the course of treatment for mild to moderate traumatic brain injuries, whereas in the context of litigation a full neuropsychological workup is essential to substantiating all aspects of the injury, including not only the cognitive aspects of the injury but the emotional and social impacts as well.

In the course of treatment, patients are often sent home from the ER after sustaining a brain injury with instructions to follow up with their general physician if symptoms persist. In many of these cases the provider has ruled out a skull fracture or brain hemorrhage via basic radiology (CT scan, MRI), leaving the patient to advocate for herself in order to receive further evaluation or treatment.

Patients experiencing brain injury symptoms (such as confusion, lethargy, dizziness and loss of balance, mood swings, depression, insomnia, headaches, irritability, increased sensitivity to light and sound, blurred vision, etc.) may not always be aware that their symptoms are related to the injury and may not be able to articulate all of their symptoms without being asked the right questions. This can make it difficult for a patient who has sustained a brain injury to obtain appropriate additional medical treatment on her own.

Any attorney experienced in brain injury litigation will know the best experts in the field and be willing to expend the costs to retain them. In most brain injury cases, some combination of the following experts should be retained to substantiate damages: neurologist, neuroradiologist, neuropsychologist; physiatrist and/or vocational rehabilitation specialist, certified life care planner, and an economist. The attorney will coordinate the team of experts to substantiate and quantify the loss for the duration of the client’s lifetime. In addition, the experts will make treatment recommendations that can greatly benefit the client when the case resolves and the client has the resources to pay for additional treatment that may not be covered by insurance.