Miami Personal Injury Lawyer Miami Attorneys

This great search was powered by Search Unleashed.
Help to remove this message by getting the site owner to support this software.

Personal Injuries | Miami Personal Injury Lawyer Miami Attorneys

The core mission of personal injury claims is to seek justice and compensation from the expenses incurred due to the injuries. Here at Miami Lawyer Attorney, you’ll find the

Miami Medical Malpractice Lawyer | South Florida Personal Injury

Call if you are looking for Miami Medical Malpractice, South Florida …

Prevent Driving Fatigue

DANGERS OF DRIVER FATIGUE

Car Accident Lawyers Miami – Personal Injury Attorney Miami

Almost everyone has driven while tired, but did you know that driver fatigue can be just as dangerous as driving while intoxicated? Statistics from the National Highway Traffic Safety Administration (NHTSA) show that there are over 55,000 driving fatigue accidents each year in the United States. In most cases, these driving fatigue accidents occur because drivers don’t recognize the dangers of drowsy driving.

Contact our experienced car accident lawyers and personal injury attorneys if you have been a victim.

How to Prevent Driving Fatigue:

Get Regular Sleep

Before you drive long distances, it is essential to get a good night of sleep. The National Sleep Foundation recommends at least seven hours per night.

Take a nap

If you start feeling drowsy, experts say that even a 15-minute nap can prevent driving fatigue accidents. Pull over at the nearest rest stop and take a 15-minute nap.

Avoid Large Meals

According to DriverFatigueKills.com, the typical highway fare (high-fat fast food) can make you more tired. Avoiding eating large, high-fat meals and instead snack on some fruit or granola bars.

Plan Your Drive

SmartMotorist.com warns that most driving fatigue accidents occur around 2 p.m. in the afternoon and between 2 a.m. and 6 a.m. in the morning. Avoid driving at these times if you can help it.

Drink Coffee

According to the National Sleep Foundation, two cups of coffee can decrease driver fatigue for at least a few hours. If you must keep driving and can’t pull over for a nap, head for a coffee shop.

Consequences of Fatigue Driving

Driver fatigue can contribute to accidents, injuries and fatalities. If you cause a fatigue-related crash, the consequences could be severe. According to the National Sleep Foundation, most states can bring charges against a drowsy driver if they cause an accident, and some states are even crafting specific laws. Contact our experienced car accident lawyer and personal injury attorney to learn the law. Under this law, drowsy drivers can be charged with recklessness and vehicular homicide if they cause an accident.  Driver fatigue is a serious matter and should be taken just as seriously as driving while intoxicated.

httpvh://www.youtube.com/watch?v=s-jkbhO8I2I

If you have suffered an injury due to someone else’s negligence, contact our experienced car accident lawyers and personal injury attorneys in Miami who can help explain your legal rights and options.

Must Know Facts for Every Brain Injury Lawyer

Here are some simple facts that every brain injury attorney must know:

Did you know that a person can have a serious, permanent and disabling traumatic brain injury, even though:

1. The person is not knocked out at the scene of the accident.
2. The person may be walking, talking and even exchanging his driver’s license at the scene of the accident
3. The person did not sustain any cuts, broken bones or major injuries in the accident.
4. The person may have a negative MRI, CT scan or EEG.
5. The defense doctor, or the insurance company, will find that the person is neurologically sound despite future findings of brain damage.
6. There was not a “big car crash” and that even a low speed or low impact car crash can exert sufficient force on the brain to cause a traumatic brain injury and resulting brain damage.
7. That the delay in diagnosing the brain damage is not the patient’s fault, but may be because of lack of education on this subject by the medical community.
8. The injured person gave different versions of what happened in the car accident. This is sometimes to be expected, because a person with a traumatic brain injury is a very poor historian when it comes to recalling the facts.
9. The patient only related two or three problems following the car crash and family members and close friends relate twenty or thirty problems including personality changes.
10. The person was able to continue working, but if he/she is given a new responsibility, promoted, transferred to another job or obtains new employment, he/she may have tremendous difficulty and end up getting fired.
11. The term “post concussion syndrome” may mean traumatic brain injury.
12. Attention or concentration problems following an accident may mean that the person suffered traumatic brain injury or brain damage.
13. Changes in personality or behavior following an accident, may also mean that the person suffered a traumatic brain injury
14. New brain damage symptoms may appear days, weeks or months following an accident.
15. The person has a perfect neurological exam, since this exam does not reveal the neuropsychological deficits associated with traumatic brain injury.
16. The diagnosis of traumatic brain injury, closed head brain injury, or brain damage is based on the entire battery of tests and the entire examination and not the patient’s answe

Past Verdicts and Settlements

The Shaked Law Firm, a Personal Injury law office, located in Miami, has recovered millions of dollars in settlements and verdicts for its clients throughout the State of Florida.  A complete case list of all cases are too numerous to list. The following is a small sampling of The Shaked Law Firm’s settlements and verdicts in which personal injury damages have been recovered for our clients. These results demonstrate the excellent representation provided by the Shaked Personal Injury Law Firm in a variety of case types.

Choosing a Brain Injury Lawyer

Few of us realize how pervasive the law is in our lives until we get into a dispute with someone else. Then we are amazed to discover what a tangled web of law there is, and how complex and endless the rules seem.

The threshold question in many situations involving the law is whether you can “do it yourself” or whether you need a lawyer to advise you on your rights or handle the matter for you completely.

While many “minor” disputes can adequately be handled without need of a lawyer – using Small Claims Court or Alternative Dispute Resolution – if you, a friend, or loved one sustained a catastrophic personal injury such as a traumatic brain injury, there can be no question but that you are in need of the services of a competent lawyer.

Unfortunately, we live in a day and time where millions of dollars have been spent persuading the general public (prospective jurors) that should an injured victim exercise their fundamental constitutional right by bringing suit, that individual is merely adding to an already “sue happy” society. Nothing could be further from the truth.

Where a lawsuit is not pursued, unless the injured victim is independently wealthy, the taxpayers will bear the brunt of financial responsibility. Indeed, in catastrophic cases the victim may end up institutionalized unless sufficient funds are secured in order to meet the victim’s medical and support needs.

Complicating matters further, many victims of traumatic brain injury, especially mild traumatic brain injury, are in a state of denial regarding the profound impact of the injury itself. While victims of “mild” TBI have not sustained the “catastrophic” injuries, which may cause an individual to be institutionalized, they have nonetheless sustained injuries which will have a significant impact on their vocational capabilities. In denial, job after job is lost.

Combining denial with the current disfavor regarding lawsuits may very well prove to be a recipe for disaster for the injured individual. Only a lawyer can assess the “legal health” of the injured victim – by investigating the facts, researching the latest developments in the law, applying his or her legal training and experience, and then advising the victim of his/her alternatives. A good lawyer can spot the “jagged rocks” that may lie below the waters of a seemingly simple dispute and can help the victim plan a course of action to avoid them.

The sad truth is, however, that all lawyers are not created equal. It is a very sad fact of traumatic brain injury life that many survivors will not receive adequate recompense for their injury because their lawyer did not have enough experience to know how to analyze, prepare and present a legitimate claim for damages. Many times, the blame is directly traceable to the attorney who is not forthright in the first place regarding his/her lack of experience handling cases involving traumatic brain injury. Time after time the inadequate result rests with the attorney who did not understand the seriousness of the injury simply because of its “invisible” nature.

Unfortunately, even where an injured victim has overcome denial, and has further overcome the social stigmas associated with bringing a lawsuit, s/he may nonetheless experience further “hurt” due to an association with a lawyer having no idea how to properly present claims involving traumatic brain injury. BEWARE: EDUCATION, TRAINING, AND EXPERIENCE VARIES BETWEEN LAWYERS.

At the Scarlett Law Group, we represent injured victims on a contingent fee arrangement. This means that we do not receive any fee or payment unless money is recovered on behalf of the injured person, and then the attorney fee is paid as a percentage of the amount recovered. [Contingent Fee].

What this means is that you have the absolute ability to hire the most qualified attorney specializing in representing individuals sustaining traumatic brain injury. Through the use of the Contingent Fee Agreement, and given that there are excellent attorneys around the United States willing to advance the expenses in connection with the prosecution of a TBI case, injured victims have the ability to hire the most qualified attorneys and need not settle for or accept inexperienced attorneys to handle their cases.

Through the contingency fee, you have the ability to hire a qualified attorney in a crucial situation, and you need not pay that attorney unless they successfully perform. This is a powerful position to be in. Do not underestimate your position. After all, the results of your lawsuit will have an important and long-term impact on your quality of life. Just as you would not rush to purchase any item of consumer goods, nor should you hastily choose a lawyer to represent you.

We at Shaked, P.A., are committed to handling claims of individuals sustaining traumatic brain injury. We are committed to spending the time with you and your family members to gain a deep understanding for each and every way the injury has affected your life. We are committed to spend the necessary time in order you understand your rights in the progress of your case. Our staff is committed to trying to make your life easier, and we will endeavor to put you in contact with support groups and treating doctors as your case may require.

Given the importance of your choice of counsel, you should be prepared to meaningfully question prospective lawyers in order to ascertain his or her qualifications to handle your case.
You are about to embark on one of the most important decisions of your life, to wit: The choice of the right lawyer to represent you. You are armed with a powerful tool, the Contingency Fee Agreement. This Agreement allows you to retain experienced counsel without having to pay hundreds of dollars per hour up front. Please, do not make your decision cavalierly. Ensure that you are comfortable with the counsel of your choice. Ensure that counsel has the confidence and experience to properly handle your case. The path is a difficult one, and the choice of counsel can make all the difference in the world.

Florida Wrongful Death Act – your rights

Disclaimer:  This is part of the 2008 version of Florida Statutes and it is offered for general information purposes.  The statutes on this site should not be relied on without reviewing your legal situation with an experienced lawyer and making sure you are using the appropriate version of the statute for your case.  The provisions applicable to your potential claim may or may not be the version that was in effect at the time of the incident because some changes to statutes are retroactive and some changes are not.  Other statutes and other case law interpreting or applying these statutes may also apply to your case.

(The information on this site applies to Florida only)

768.16  Wrongful Death Act.–Sections 768.16-768.26 may be cited as the “Florida Wrongful Death Act.”

History.–s. 1, ch. 72-35; s. 105, ch. 2003-1.

768.17  Legislative intent.–It is the public policy of the state to shift the losses resulting when wrongful death occurs from the survivors of the decedent to the wrongdoer. Sections 768.16-768.26 are remedial and shall be liberally construed.

History.–s. 1, ch. 72-35; s. 106, ch. 2003-1.

768.18  Definitions.–As used in ss. 768.16-768.26:

(1)  “Survivors” means the decedent’s spouse, children, parents, and, when partly or wholly dependent on the decedent for support or services, any blood relatives and adoptive brothers and sisters. It includes the child born out of wedlock of a mother, but not the child born out of wedlock of the father unless the father has recognized a responsibility for the child’s support.

(2)  “Minor children” means children under 25 years of age, notwithstanding the age of majority.

(3)  “Support” includes contributions in kind as well as money.

(4)  “Services” means tasks, usually of a household nature, regularly performed by the decedent that will be a necessary expense to the survivors of the decedent. These services may vary according to the identity of the decedent and survivor and shall be determined under the particular facts of each case.

(5)  “Net accumulations” means the part of the decedent’s expected net business or salary income, including pension benefits, that the decedent probably would have retained as savings and left as part of her or his estate if the decedent had lived her or his normal life expectancy. “Net business or salary income” is the part of the decedent’s probable gross income after taxes, excluding income from investments continuing beyond death, that remains after deducting the decedent’s personal expenses and support of survivors, excluding contributions in kind.

History.–s. 1, ch. 72-35; s. 66, ch. 77-121; s. 40, ch. 77-468; s. 1, ch. 81-183; s. 3, ch. 89-61; s. 1, ch. 90-14; s. 1167, ch. 97-102; s. 107, ch. 2003-1.

768.19  Right of action.–When the death of a person is caused by the wrongful act, negligence, default, or breach of contract or warranty of any person, including those occurring on navigable waters, and the event would have entitled the person injured to maintain an action and recover damages if death had not ensued, the person or watercraft that would have been liable in damages if death had not ensued shall be liable for damages as specified in this act notwithstanding the death of the person injured, although death was caused under circumstances constituting a felony.

History.–s. 1, ch. 72-35.

768.20  Parties.–The action shall be brought by the decedent’s personal representative, who shall recover for the benefit of the decedent’s survivors and estate all damages, as specified in this act, caused by the injury resulting in death. When a personal injury to the decedent results in death, no action for the personal injury shall survive, and any such action pending at the time of death shall abate. The wrongdoer’s personal representative shall be the defendant if the wrongdoer dies before or pending the action. A defense that would bar or reduce a survivor’s recovery if she or he were the plaintiff may be asserted against the survivor, but shall not affect the recovery of any other survivor.

History.–s. 1, ch. 72-35; s. 1168, ch. 97-102.

768.21  Damages.–All potential beneficiaries of a recovery for wrongful death, including the decedent’s estate, shall be identified in the complaint, and their relationships to the decedent shall be alleged. Damages may be awarded as follows:

(1)  Each survivor may recover the value of lost support and services from the date of the decedent’s injury to her or his death, with interest, and future loss of support and services from the date of death and reduced to present value. In evaluating loss of support and services, the survivor’s relationship to the decedent, the amount of the decedent’s probable net income available for distribution to the particular survivor, and the replacement value of the decedent’s services to the survivor may be considered. In computing the duration of future losses, the joint life expectancies of the survivor and the decedent and the period of minority, in the case of healthy minor children, may be considered.

(2)  The surviving spouse may also recover for loss of the decedent’s companionship and protection and for mental pain and suffering from the date of injury.

(3)  Minor children of the decedent, and all children of the decedent if there is no surviving spouse, may also recover for lost parental companionship, instruction, and guidance and for mental pain and suffering from the date of injury. For the purposes of this subsection, if both spouses die within 30 days of one another as a result of the same wrongful act or series of acts arising out of the same incident, each spouse is considered to have been predeceased by the other.

(4)  Each parent of a deceased minor child may also recover for mental pain and suffering from the date of injury. Each parent of an adult child may also recover for mental pain and suffering if there are no other survivors.

(5)  Medical or funeral expenses due to the decedent’s injury or death may be recovered by a survivor who has paid them.

(6)  The decedent’s personal representative may recover for the decedent’s estate the following:

(a)  Loss of earnings of the deceased from the date of injury to the date of death, less lost support of survivors excluding contributions in kind, with interest. Loss of the prospective net accumulations of an estate, which might reasonably have been expected but for the wrongful death, reduced to present money value, may also be recovered:

1.  If the decedent’s survivors include a surviving spouse or lineal descendants; or

2.  If the decedent is not a minor child as defined in s. 768.18(2), there are no lost support and services recoverable under subsection (1), and there is a surviving parent.

(b)  Medical or funeral expenses due to the decedent’s injury or death that have become a charge against her or his estate or that were paid by or on behalf of decedent, excluding amounts recoverable under subsection (5).

(c)  Evidence of remarriage of the decedent’s spouse is admissible.

(7)  All awards for the decedent’s estate are subject to the claims of creditors who have complied with the requirements of probate law concerning claims.

(8)  The damages specified in subsection (3) shall not be recoverable by adult children and the damages specified in subsection (4) shall not be recoverable by parents of an adult child with respect to claims for medical negligence as defined by s. 766.106(1).

History.–s. 1, ch. 72-35; s. 2, ch. 81-183; s. 1, ch. 85-260; s. 2, ch. 90-14; s. 1169, ch. 97-102; s. 1, ch. 2002-44; s. 66, ch. 2003-416.

768.22  Form of verdict.–The amounts awarded to each survivor and to the estate shall be stated separately in the verdict.

History.–s. 1, ch. 72-35.

768.23  Protection of minors and incompetents.–The court shall provide protection for any amount awarded for the benefit of a minor child or an incompetent pursuant to the Florida Guardianship Law.

History.–s. 1, ch. 72-35.

768.24  Death of a survivor before judgment.–A survivor’s death before final judgment shall limit the survivor’s recovery to lost support and services to the date of his or her death. The personal representative shall pay the amount recovered to the personal representative of the deceased survivor.

History.–s. 1, ch. 72-35; s. 1170, ch. 97-102.

768.25  Court approval of settlements.–While an action under this act is pending, no settlement as to amount or apportionment among the beneficiaries which is objected to by any survivor or which affects a survivor who is a minor or an incompetent shall be effective unless approved by the court.

History.–s. 1, ch. 72-35.

768.26  Litigation expenses.–Attorneys’ fees and other expenses of litigation shall be paid by the personal representative and deducted from the awards to the survivors and the estate in proportion to the amounts awarded to them, but expenses incurred for the benefit of a particular survivor or the estate shall be paid from their awards.

History.–s. 1, ch. 72-35.

If you have lost a loved as a result of another’s negligence, please contact the personal injury lawyers of the Shaked Law Firm, P.A. in Miami, Florida for a free consultation about your case.

Motorcycle Accidents – You need an injury lawyer

Who acts first after a motorcycle accident can make a difference.  Insurance companies immediately hire investigators and adjuster to visit the scene and secure witness statements and so should you.  The Shaked Law Firm our experienced trial lawyers with knowledge it takes to get the settlement you deserve. 

Determining who is legally responsible in a traffic accident depends upon the carelessness, among other factors, of the alleged wrongdoer.  In freeway and highway traffic accidents, state traffic laws, like the Florida Motor Vehicle laws, provide the rules of the road.  Violating these rules and then causing a collision could create a rebut-able presumption of negligence – aka negligence per se – and ultimate liability. In many situations, car operators could be liable for a traffic accident even if they were driving at or below the posted speed limit, or otherwise obeying the laws of the state. This is because, for example, a “safe” speed and not the posted speed is what is required for a responsible driver. Another example would be foggy conditions, or cases where the sun is in the car driver’s eyes, impairing visibility.

These conditions would require extra care and caution when driving on the road, like pulling over to the curb when safe, or driving slower.

Find Your Florida Motorcycle Attorneys Now!

At the Shaked Law Firm, Miami Injury Lawyers, our staff of seasoned personal injury lawyers litigate freeway accidents and highway accidents throughout Florida, with local attorneys in Dade, Broward, and Palm Beach Counties. These include injuries to riders of motorcycles.

Injuries from Motorcycle accidents are not the same as those in an enclosed passenger car with seat-belts and airbags. In fact,they are not even close. Motorcycles are usually two wheeled vehicles that will usually eject the rider in a high speed crash, or low speed crash. Even pads and helmets do little to protect the motorcycle riders in a crash. This can leave the rider with a ruptured disc, a serious brain injury, or even result in wrongful death. Because we are motorcycle attorneys with vast knowledge of tort laws, we can help guide you through the legal quagmire that other motorcycle accident attorneys either don’t have the time, or the desire to take on when valuating your damages claims.

 The local attorneys at the Shaked Law Firm are experienced trial and injury attorneys who will aggressively litigate your case to make sure you recover the maximum damages allowable under the law. These damages include, monetary compensation for mental and physical pain and suffering. Our experienced staff of legal professionals know exactly what we need to do in order to maximize the value of your case. Your medical doctors and hospitals need to be paid for and the wrongdoer should be forced to pay under our tort system.

 

This avoids self help, like the days of the wild west. In a civilized society such as ours, the evil doer pays for his/her neglience in money damages, i.e., a settlement or jury trial. We work with the very best and most talented experts to investigate your case and learn the finer points of your individual fact
patterns.

 

Our legal team has vast legal knowledge of the anatomy of motorcycle accidents. You should know your legal rights if you have injured yourself while riding a motorcycle. Don’t guess at the value of your case!

If you have been seriously injured in a motorcycle accident in Miami or Broward County, our attorney hot-line is available 24 hours for your telephone call at (877) LAW-0080, (305) 937-0191 or e-mail. We will provide you with a free consultation.  We are experienced motorcycle accident injury attorneys who can help you. Our law firm litigates personal injury cases on a contingency fee basis. If we do not recover for you, we don’t charge you a fee.

Please visit our website dedicated to motorcycle riders (www.personalinjuryrider.com) to read more about about our experienced motorcycle attorneys, our Motorcycle Accident Articles, Motorcycle Accident Resources; and learn about the anatomy of these accidents and how to file a motorcycle insurance claim.

Brain Injuries – Overview of the Invisible Injury

Brain injuries are devastating, life changing, and they generally are not obvious to the casual observer. In fact, traumatic brain injuries are called the “silent epidemic” and the “invisible injury” largely in part because victims sometimes aren’t even aware that something is wrong.

Traumatic Brain Injury (TBI) is not like any other injury. Sadly, because many of the symptoms of “mild” to “moderate” traumatic brain injury are subtle, and because the injury commonly avoids detection on our most sophisticated hospital imaging equipment, it is common for victims to go undiagnosed. This is especially so in the emergency room.

Due to the invisible nature of the injury, victims of traumatic brain injury only rarely receive prompt treatment for their physical and cognitive impairment. Not uncommonly, victims’ early medical charts are devoid of any mention of “head injury” or “cognitive impairment”. It is only later, if lucky, that a health care professional validates the victims” injury, and treatment finally ensues.

As with most misunderstood injuries, society and “old school” health care practitioners, are apt to label the TBI victim a malingerer, or worse. Because victims of traumatic brain injury appear outwardly just as they did before the injury, it should come as no surprise that many victims describe their post-injury experience as including progressive social isolation together with alienation from even immediate family.

“Left to fend for themselves, the victims of traumatic brain injury, already confused by their inability to be the people they were prior to the injury, now face the daunting task of demonstrating that an injury they do not understand and cannot comprehend is producing the confusion they cannot communicate.”

Practically, victims of TBI are unable to process information at pre-injury rates of speed. Nor is the range of subject matter about which an individual can think the same for a victim of traumatic brain injury. Accurate judgment becomes difficult, at best.

Communication is oftentimes stifled, and the ability to conform behavior is impaired. Violent behavior may manifest as a result of frustration and inability to respond in a pre-morbid (pre-injury) manner. Headaches are common, and smell and taste can be affected. Memory and recall are often times profoundly affected.

Conscious or unconscious awareness of the situation becomes the private “hell” of the victim, who is alone and unable to diagnose or resolve the injury. Describing this unfortunate circumstance, Dr. Antoinette R. Appel has stated: “Left to fend for themselves, the victims of traumatic brain injury, already confused by their inability to be the people they were prior to the injury, now face the daunting task of demonstrating that an injury they do not understand and cannot comprehend is producing the confusion they cannot communicate.”

What is “Mild” Traumatic Brain Injury?

Historically, words such as “mild”, “moderate”, and “severe” were utilized to define brain injury. For many years, these terms were utilized based on duration of loss of consciousness.
Today, it is universally accepted that brain injury can occur without loss of consciousness,without direct external trauma to the head, and without positive findings on CT, MRI, or other sophisticated diagnostic testing.
Acknowledging this latter point, in the 1995 Journal of Neurotrauma it is stated:
“Although current computerized tomography (CT) and magnetic resonance imaging (MRI) techniques have shown great utility in diagnosing various aspects of traumatic brain injury, damage resulting from mild diffuse brain injury often goes undetected with these procedures.” (Emphasis added). [Smith, D.H.; Meaney, D.F.; Lenkinski, R.E.; Alsop, D.C.; Grossman, R.; Kimura, H.; McIntosh, T.K.; Gennarelli, T.A.; (1995) New Magnetic Resonance Imaging Techniques for the Evaluation of Traumatic Brain Injury. J.Neurotrauma 12(4): 573-577]
We at Shaked, P.A. find it repugnant to utilize terms such as “mild” or “moderate” to describe a permanent brain injury. However, until the lexicon of health care practitioners, experts, and others change, we seem destined to face use of these terms to describe brain injury. We must, therefore, assist all those seeking assistance, and even those who are not, with the true meaning of the words “mild” and “moderate” as they pertain to brain injury. When it describes a brain injury, we believe the word “mild” is synonymous with “serious”.
The Mild Traumatic Brain Injury Committee of the Head Injury Interdisciplinary Special Interest Group of the American Congress of Rehabilitative Medicine define mild traumatic brain injury as follows:
DEFINITION:
“A patient with mild traumatic brain injury is a person who has had a traumatically induced physiological disruption of brain function, as manifest by at least one of the following:
1. Any period of loss of consciousness;
2. Any loss of memory for events immediately before or after the accident;
3. Any alteration in mental state at the time of the accident (i.e., feeling dazed, disoriented, or confused); and
4. Focal neurological deficits that may or may not be transient; but where the severity of the injury does not exceed the following:
* Post-traumatic amnesia (PTA) not greater than 24 hours;
* After thirty minutes, an initial Glasgow Coma Scale (GCS) of 13-15;
* Loss of consciousness of approximately thirty minutes or less;
COMMENTS:
This definition includes:
1. The head being struck;
2. The head striking an object;
3. The brain undergoing an acceleration/ deceleration movement (i.e., whiplash) without direct external trauma to the head. It excludes stroke, anoxia, tumor, encephalitis, etc. Computed tomography magnetic resonance imaging, electroencephalogram or routine neurological evaluations may be normal. Due to the lack of medical emergency, or the realities of certain medical systems, some patients may not have the above factors medically documented in the acute stage. In such cases, it is appropriate to consider symptomology that, when linked to a traumatic head injury, can suggest the existence of a mild traumatic brain injury.
SYMTOMOLOGY:
The above criteria define the event of mild traumatic brain injury. Symptoms of brain injury may or may not persist, for varying lengths of time, after such a neurological event. It should be recognized that patients with mild traumatic brain injury can exhibit persistent emotional, cognitive, behavioral and physical symptoms, alone or in combination, which may produce a functional disability. These symptoms generally fall into one of the following categories, and are additional evidence that a mild traumatic brain injury has occurred.
1.Physical symptoms of brain injury (e.g., nausea, vomiting, dizziness, headache, blurred vision, sleep disturbance, quickness to fatigue, lethargy, or other sensory loss) that cannot be accounted for by peripheral injury or other causes;
2.Cognitive deficits (e.g., involving attention, concentration, perception, memory, speech/language or executive functions) that cannot be completely accounted for by emotional state or other causes; and
3.Behavioral changes and/or alterations and degree of emotional responsivity (e.g., irritability, quickness to anger, disinhibition, or emotional lability) that cannot be accounted for by a psychological reaction to physical or emotional stress or other causes.
COMMENTS:
Some patients may not become aware of, or admit, the extent of their symptoms until they attempt to return to normal functioning. In such cases, the evidence for mild traumatic brain injury must be reconstructed. Mild traumatic brain injury may also be overlooked in the face of more dramatic physical injury (e.g., orthopedic or spinal cord injury). The constellation of symptoms has previously been referred to as minor head injury, post-concussion syndrome, traumatic head syndrome, traumatic dephalgia, postbrain injury syndrome and post-traumatic syndrome.” J Head Trauma Rehabil 1993:8(3):86-87

Statistics of Traumatic Brain Injury

If trauma-caused brain injury were instead disease-resulting, it would be labeled a “plague of epidemic proportions. Only slightly exaggerated, the fact remains that the frequency of traumatic brain injury is extremely high.

Unfortunately, as could be expected, the failure to properly diagnose and even define brain injury compromised the accuracy of early studies, whose goal was to track the frequency of traumatic brain injury in the United States of America. These studies are commonly referred to as “epidemiological studies“.

For example, many of the early studies (1935-1981) required one or more of the following criterion for inclusion: (i) loss of consciousness; (ii) hospital admission; and/or (iii) positive neuro-radiological findings. Moreover, these earlier studies sporadically did not include cases in which the patient actually died before reaching the hospital.

Nonetheless, even utilizing the outmoded, inaccurate criterion of the past, frequency rates of traumatic brain injury were found as high as 10 per 175 patients, and only as low as 10 per 600 patients.

Modern studies focusing on the frequency of traumatic brain injury (1981-present) have attempted to resolve inaccurate definitional difficulties and have looked beyond hospital discharge coding problems. These studies tend to be much more accurate and demonstrate an alarming frequency rate of traumatic brain injury.

Based on the modern studies, it is likely that the annual incidents of new head injuries treated in hospitals in this country is 400 per 100,000 patients treated. Accordingly, more than 1,000,000 new head injuries are treated in hospitals each year. Even these studies, however, ignore the numerous cases of “mild” traumatic brain injury in which the patient is never hospitalized.

Corroboration for these numbers comes from the most recent data from the Center’s for Disease Control and Injury Prevention (CDC): It is now estimated that there are 5.3 million children and adults living with the consequences of sustaining a traumatic brain injury in the United States. This number represents nearly 2% of the population.

TBI does not discriminate. It can happen to a child or adult of any age, gender, race, religion, or socio-economic status. The risk of TBI is highest among adolescents, young adults and persons over the age of 75. In comparing the national prevalence rate for TBI with other more commonly cited and discussed disabilities, it is easily understood why TBI is often referred to as the “silent epidemic”. Examples of other prevalence rates (from CDC) follow:

400,000 with Spinal Cord Injuries;

500,000 with Cerebral Palsy;

2.3 million with Epilepsy;

3.0 million with Stroke disabilities;

4.0 million with Alzheimer’s Disease;

5.3 million with TRAUMATIC BRAIN INJURIES;

5.4 million with Persistent Mental Illness;

and 7.2 million with Mental Retardation.

An estimated TWO MILLION people receive a traumatic brain injury each year and someone will sustain a brain injury every fifteen seconds. An estimated ONE MILLION people are treated for TBI and released from hospital emergency departments each year. Each year 230,000 Americans are hospitalized (longer than ER booking) as a result of TBI. Each year 80,000 Americans experience the onset of long-term disability as a result of sustaining a TBI. More than 50,000 people die every year as a result of TBI.

Vehicle crashes are the leading cause of brain injury. They account for 40% of all TBI’s Falls are the second leading cause of TBI and the leading cause of brain injury in the elderly. In 1990, Congress responded to the reported increase in TBI by amending the Individuals with Disabilities Education Act (PL 101-476) to include TBI as a separate disability category. [See also, Code of Federal Regulations, Title 34, Section 300.7(b)(121)].

In response to recommendations of the Interagency Head Injury Task Force, Representative Jim Greenwood introduced the first version of the TBI Act during the 103rd Congress. He was later joined by Henry Waxman as lead co-sponsor in the House. Senator Orrin G. Hatch and Senator Edward M. Kennedy introduced similar legislation in the Senate. The Legislation was re-introduced in the 104th Congress and signed into law as PL 10-166 on July 29, 1996. This Legislation provides for CDC surveillance of occurrence and cause of TBI (hence the statistics above), as well as development of medical treatment and prevention. Grants and other public funding mechanisms are also included in the legislation. In introducing S-96 on January 4, 1995, Senator Hatch stated: “Sustaining a traumatic brain injury can be both catastrophic and devastating. The financial and emotional costs to the individual, family, and community are enormous. Traumatic Brain Injury is the leading cause of death and disability among Americans under the age of 35. In the State of Utah, for example, the main affected age is 28, which is often the beginning of an individual’s maximum productivity * * *.”

Senator Kennedy’s introductory statement included the following: “In 1988, Congress recommended the Secretary of Health and Human Services establish an Interagency Head Injury Task Force to identify gaps in research, training, medical management, and rehabilitation. This legislation responds to the prevention, research, and service needs identified by the Task Force. This Bill will promote coordination in the delivery system and assure greater access to services for victims suffering from the disabling consequences of these injuries. By improving the quality of care, we can reduce severely the disabling effects and reduce the heavy toll from these injuries”.

Unfortunately, while this legislation may help, the public (taxpayer) cannot foot the entire bill resulting from these injuries, especially where the injury results from the negligent or intentional wrongs of another. Moreover, due to advances in medical technology, especially in the diagnostic areas of medicine (PET, MRI, etc.), brain injury is likely to be diagnosed at greater rates than ever before. It is not necessarily that there are more brain injuries occurring today, but due to poor diagnostic capabilities in the past, these injuries were simply overlooked, and unfortunately, left untreated for the most part.

Next Page »