Head Injury

Traumatic brain injury (also known as TBI) is the generic term for any kind of blunt-force trauma to the head (also known as "the cranium") that may cause serious disability or even death. A TBI can include everything from a slight concussion to permanent and debilitating brain damage. Usually, most of the damage comes from the soft tissue of the human brain being knocked about the hard encasing of the human skull (commonly known as “concussions”), resulting in bruising and damage to the brain.

There are three basic kinds of TBIs, including:

1. Cerebral contusion - This is a bruise of the soft tissue of the brain. This happens in twenty to thirty percent (20-30%) of all head injuries.

2. Penetrating head injury - This is also referred to as an “open-head injury”. These are usually caused by objects that fracture the bones of the skull.

3. Anoxic brain injury - This a type of brain injury in which the brain suffers from “anoxia”, meaning that it is deprived of oxygen.

Furthermore, symptoms of a TBI are potentially debilitating and may include:

1. Loss of consciousness for any period of time (including coma)

2. Feeling confused, disoriented, and/or dazed as well as dizziness or imbalance

3. Nausea and/or vomiting

4. Fatigue and/or drowsiness

5. Difficulties with speech

6. Blurry vision, bad taste in your mouth, and/or ringing in the ears

7. Inability to concentrate or remember anything

8. Changes in mood and/or perception

9. Persistent and/or severe headache

10. Convulsions and/or seizures

11. Clear fluid leaking from the nose and/or ears

12. Weakness and/or numbness in the extremities

If you exhibit any of these symptoms, then you must see a physician as quickly as possible. One of the grave dangers of a TBI is that the symptoms do not indicate just how severe the injury actually is, meaning that you run the risk of collapsing or even dying at a later time.

There are various occupations that carry a higher risk of head injury or TBI, including:

1. Construction workers

2. Emergency first responders

3. Manufacturing and warehouse workers

4. Farmers

5. Race car drivers

6. Professional athletes

7. Fishermen

8. Forestry personnel

9. Delivery workers

10. Transportation workers

Within these various industries, construction workers are, by a long shot, the most susceptible to these types of brain injuries. They remain unfortunately common on construction sites despite the construction industry’s clear efforts to minimize and/or control them. Every visitor to a construction site is required, usually by the presiding insurance company, to wear a hard hat, but falling equipment and/or debris still cause many TBIs per year.

Emergency first responders, particularly firefighters, are the second most likely to suffer from a TBI. This is because they are frequently called upon to enter dangerous and unstable structures, whereby any piece of debris can come crashing down on their heads. Even though firefighters also wear helmets, they are still highly vulnerable.

Finally, the third most common are two industries in which heavy machinery is frequently used: manufacturing and warehouse professionals. Within the manufacturing sector, most factories require the use of large, dangerous pieces of machinery in order to build their wares. Furthermore, the storage of these goods in warehouses requires the use of large-scale machinery to transport and stack them, thereby making the warehouse workers highly susceptible to suffering from a TBI.

The most important thing is to take action. These TBIs are extremely serious and they may result in death or permanent disability. If you have taken any impact to the head, even if it did not seem serious, then immediately seek out medical attention. Not only is it important to seek out treatment for your personal health, but also to bolster your workers’ compensation case.

Once you are at the doctor’s office, then they will have you undergo medical imaging to determine the extent of your injuries. The most common are X-rays, to determine any damage to the bone, and MRIs (magnetic resonance imaging) to determine any damage to underlying soft tissue. The doctor can then give you a preliminary diagnosis and a prognosis for the treatment of your head injury.

Once you have sought out medical treatment, the next important step is to report your injury to your employer. In the state of California, you have thirty (30) days to do this. If you do not complete this step within this period of time, then it is almost certain that your claim will be rejected outright. You can do this with a Notification Letter, the steps of which should follow these basic guidelines:

1. Give your basic information such as name, date of birth, date of injury, and social security number.

2. Clearly, state where you were working for your employer on the date of the injury and that you suffered your head injury while performing your professional duties.

3. In order to further strengthen your case, state exactly what you were doing at the time that you suffered the injury.

4. In order to avoid having your claim denied on the basis of a preexisting condition, you must state that you have not suffered any prior injury to your brain and/or head. If you did have a preexisting condition and/or injury, then you could still be eligible for workers’ compensation, though the final amount will be considerably less. The state of California will consider a preexisting condition as being “exacerbated” by a new injury.

5. Communicate any information from your physician regarding your diagnosis, prognosis, and any treatments that you may have to undergo. Do not speculate on what your injuries are and instead stick to hard facts that have been related to you by your diagnostician. If you do not have a full diagnosis by the time you compose and send this Notification Letter, then at least state what kind of treatment you are receiving for your traumatic brain injury.

6. Request a list of physicians, including specialists in brain injuries like neurologists, who are under your employer’s Workers’ Compensation insurance policy.

7. Because you may not know the full amount yet, California law requires that you make an effort of “good faith” to notify your employer of the various costs that are being incurred throughout the course of your diagnosis and treatment.

8. Confirm with your employer that they have also done their part in relation to your claim, including that they have notified the Division of Workers’ Compensation (DWC) for the state of California.

9. Finally, it is simply prudent to end your letter with a promise that you intend to be fully cooperative in the resulting investigation and process. This is head off any potential accusations that you have not been fully cooperative since the beginning of the entire process.

Furthermore, you must also take action to notify the Division of Workers’ Compensation (DWC) for California via their office at 455 Golden Gate Avenue, Second (2nd) Floor in San Francisco, CA 94102. Their direct office line is (415) 703-5020 and their toll-free number is 1-800-736-7401. The DWC is overseen by the Department of Industrial Relations (also known as the DIR), which is the state regulatory agency that deals with these workers’ compensation cases.

Per California state law, all employers must provide workers’ compensation insurance, even if they employ only one (1) person. There are a handful of exceptions, but by and large, if you are an employee working in the state of California in either the private or public sector, then you will be covered by the workers’ compensation insurance supplied by your employer.

This workers’ compensation can provide a variety of benefits if you suffer a head injury while on the job. That, in essence, means any activity that you are undertaking that is related to your employment. It does not necessarily have to occur on the premises of your employer (if, for example, you are professionally required to travel for work).

However, many unscrupulous employers will try to convince their employees to accept group insurance benefits rather than applying for their workers’ compensation. This is merely a deliberately misleading tactic to trick you; in reality, any head injury and/or brain illness that was caused by your work must be covered by the mandatory workers’ comp insurance that every California employer is legally compelled to supply.

The workers’ comp benefits are clearly preferable to any group insurance benefits, primarily because:

1. They are not subject to any kind of income tax.

2. Under California law, workers’ compensation may result in disability payouts that can be collected for much longer than under group insurance. Under some circumstances, these payouts may be permanent.

3. These same disability payouts are paid in a higher amount than the benefits available under group insurance.

4. If you are the victim of a TBI that has resulted in only partial disability, then you can receive partial payouts to offset your decrease in productivity. Most brain injuries result in weekly compensation benefits that equal two-thirds (⅔) of your income.

5. Brain injuries can result in lengthy hospital stays and extensive treatment that is financially demanding. Under workers’ compensation benefits, you are entitled to have all these medical bills covered.

It is likely that your employer will try to use the unsavory tactic of deferring you to group insurance; if you have faced this, then you should contact a worker’s compensation lawyer right away. The Workers Compensation Attorney Law Firm is experienced in these types of cases, and we have even observed some dishonest employers taking advantage of the injured employee’s dazed and confused state following their brain injury.

In order to give your attorney the best chance of securing a significant settlement for your brain injury, you must be sure to share all the facts of your case with them. This will keep them from encountering any surprises throughout the discovery process or even during the trial, either of which may cripple your case to the point of ruining your chances for a financial settlement.

It is absolutely crucial that you share with them any information about your preexisting condition (if applicable), any prior injuries or illnesses, and any past workers’ comp claims. With all of this information, your attorney can craft a strategy that is specific to your case and your needs, thereby granting you the greatest chance of success.

Furthermore, share any and all prior medical problems you may have had, including:

1. Any traumatic injuries where you required immediate medical intervention (not just brain injuries)

2. Vehicular collisions, even ones where you did not seek out medical attention (it is possible that you may have suffered delayed injuries to your brain and/or spine)

3. Any brain injuries that you incurred while playing sports

4. Any past medical conditions that required treatment

5. Any brain or spinal conditions that resulted in chronic pain and/or stiffness

It is also wise that you inform your attorney about any prior litigation and/or claims that you may have been involved in. This will allow your attorney to know your complete legal history and to avoid any unwanted surprises throughout the course of the investigation and/or trial.

Finally, you must provide your current attorney with all documentation as it relates to these prior claims and/or injuries as well as all pertinent contact information for all the physicians who treated your conditions. As part of the investigatory process for your workers’ comp claim, your lawyer can go over these various documents and medical diagnoses to determine which facts differentiate your current brain injury from any that you may have suffered from in the past.

Despite all this, there is still every possibility that the insurance company will deny your claim.

Nearly a third (⅓) of the time, the process of denying your workers’ comp will supposedly be due to a “preexisting condition”. The phrase “preexisting condition” refers to any medical condition, injury, and/or disease that predates the point in time when a claimant’s health benefits go into effect.

The most common pre existing conditions in brain injuries are:

1. Hematoma - This when some form of blunt-force trauma causes clotting in the tiny blood vessels that are present in soft tissue. In a brain injury, these hematomas can lead to extensive clotting which then results in a buildup of pressure within your skull, thereby causing you to lose consciousness and potential brain damage.

2. Hemorrhage - This is the medical term for any kind of uncontrolled, internal bleeding. This hemorrhaging can occur in the empty space surrounding your brain (known as a “subarachnoid hemorrhage”) or within the soft tissues that make up your brain (known as an “intracerebral hemorrhage”). Either can result in serious brain damage and death to delicate brain tissue.

3. Prior history of concussions - If a patient has a history of extensive concussions, then it is likely that they will develop a serious brain disorder known as “chronic traumatic encephalopathy” (also known as CTE). This is a form of permanent brain damage and can result in a range of serious symptoms.

4. Prior history of edema - Any kind of brain injury can lead to edema (swelling) when the soft tissue is traumatized and/or damaged. Brain edema is particularly dangerous, however, because if the brain swells, it has nowhere to expand to; it can potentially cause the skull to exert a tremendous amount of pressure on the fragile tissues of the human brain.

5. Skull fractures - This is any kind of break or fracture to the hard bone that encases the brain. Prior fractures will result in an area of the skull that is usually more vulnerable to outside trauma and that can more easily be broken.

6. Diffuse axonal injury - This is an injury to the brain that does not result in a hemorrhage but still creates tremendous damage to the cells. This is one of the most dangerous forms of brain injury as it almost always results in serious edema, thereby resulting in tremendous pressure being applied to the fragile tissues of the human brain.

It is important to remember that workers’ comp only covers injuries and/or illnesses that are caused by the claimant’s place of work and/or the type of work that they do. However, suffering from a preexisting condition does not necessarily mean that you cannot receive workers’ comp benefits. This is because the state of California concedes that a preexisting condition can potentially be “exacerbated” by a head injury sustained on the job, thereby entitling you to some percentage of a workers’ comp payout.

Your employer may also claim that you are not eligible for workers’ comp because your brain injury is not as severe as you claimed, your brain injury did not occur while you were on the job, or that your brain injury was actually caused by your own negligence and/or illegal conduct (such as drinking on the job).

As stated above, most head injuries result in a workers’ compensation payment that is equivalent to two-thirds (⅔) of your income. However, the level of disability that your TBI has caused you will determine the exact level of compensation that you receive.

TBIs are more serious than other types of injuries because they generally result in permanent injury. This is because the nervous tissue that is damaged in a TBI is less prone to recovery than other types of tissue in the human body. As a result, most TBIs result in some level of permanent disability.

Under these circumstances, you can either be:

1. Permanently partially disabled (also known as PPD) - Under this medical classification, you are officially only partially impaired to return to your former level of working ability. Usually, a PPD classification will entitle you to payments over a period of time (weeks or months) that are based on your impairment rating, age, and/or level of income. However, if this PPD is still serious enough to keep you from returning to a high-paying position, then you could find yourself in a difficult financial situation.

2. Permanently totally disabled (also known as PTD) - Under this medical condition, your impairment is total, permanent, and precludes you from returning to work. You will be entitled to lifelong compensation, although you must work with your workers’ compensation attorney to ensure that you receive the maximum compensation possible. In order to do this, be sure you properly document your lost wages as well as keep track of your medical bills and/or caretaker services.

Obviously, attaining PTD status is preferable if your TBI is severe enough; this will ensure that you are financially set to the point where you can properly treat your serious medical condition and maintain a lifestyle based on your rate of pay before your head injury.

However, under some circumstances, the insurance company will offer you what is known as a “clincher deal”. This is a lump sum that is available immediately and results in your waiving the right to any future benefits. Many TBI victims will jump at this opportunity, believing that it is a more financially advantageous deal. These “clincher deals” should only be considered and agreed upon after having your workers’ compensation attorney look over all the details to give you an accurate assessment of the total payout.

This is particularly true if the victim of the TBI has suffered a decrease in intellectual capacity. In some particularly egregious cases that we have encountered, insurance companies take advantage of TBI victims who have not been fully able to comprehend the gravity of their legal interactions. If you have a loved one who has suffered this kind of TBI and is now mentally disabled, then be sure that you retain our firm so that we can represent them as we keep their best interests paramount to every legal maneuver we make.

If you or a loved one have suffered a traumatic brain injury (TBI), then be sure that you seek out the best possible legal help. This will keep unscrupulous employers and insurance companies from taking advantage of the situation and shorting you on compensation that you are legally owed. Call our work injury attorney today at 310-956-4277 for your complimentary consultation. We have helped residents of Los Angeles secure substantial workers’ comp settlements for their TBIs.