According to the National Institute of Health, approximately 1.5 million Americans sustain traumatic brain injuries each year, often caused by motor vehicle accidents or falls – both of which are workplace risks. Knowing how a traumatic brain injury is diagnosed is important for any injured worker trying to prove this type of injury in the Texas workers’ compensation system.
Confusing Terms When A Traumatic Brain Injury Is Diagnosed
Doctors commonly use three different terms when talking about head injuries in a Texas workers’ compensation claim – concussion, post concussion syndrome, and traumatic brain injury. The three terms are not exactly different things; often, a traumatic brain injury patient is said to have a concussion and suffer post concussion syndrome. Doctors sometimes use the term “concussion” interchangeably with traumatic brain injury even though a concussion is technically a mild form of a traumatic brain injury.
Post concussion syndrome, while sometimes listed as a diagnosis all by itself, is actually a group of symptoms that generally result from a mild traumatic brain injury. Post concussion syndrome consists of physical symptoms, such as headaches, and neuropsychological symptoms, such as concentration, memory, and judgment deficits, according to the Mayo Clinic. The Center for Disease Control says that a traumatic brain injury is an injury to the head arising from blunt force trauma (like falling and hitting your head) or acceleration or deceleration forces (like in a car wreck, think whiplash) with confusion, memory loss, loss of consciousness, seizures, headaches, irritability, dizziness, fatigue, or poor concentration. As the CDC definition implies, a traumatic brain injury is a distinct injury that causes functional deficits.
What About Negative Test Results?
There are two common misconceptions in how a traumatic brain is diagnosed: one, that negative brain imaging, such as CT scans of the head, or brain MRIs, means that the injured worker did not sustain a traumatic brain injury; and two, that a person must lose consciousness at the time of the injury in order to suffer a traumatic brain injury. While loss of consciousness or positive brain imaging often shows up with traumatic brain injuries, neither is required for a diagnosis. For example, the common “sudden deceleration” injuries, such as those caused by motor vehicle accidents, are difficult to detect on brain imaging because the brain “shearing,” or the stretching and tearing of the nerves involved in that mechanism of injury, is too subtle for an MRI to pick up.
Making The Diagnosis
So how do doctors appropriately diagnose a traumatic brain injury? According to the Center for Disease Control, a mild traumatic brain injury diagnosis should be considered when one or more of the following occur after a head injury: confusion or disorientation, amnesia near the time of the injury, loss of consciousness for less than thirty minutes, neurological or neuropsychological problems, and/or a score of 13 or higher on the Glascow Coma Scale. The neuropsychological symptoms include emotional, cognitive, and behavioral changes. Visual field changes and sensory loss in the upper extremities are also cited as accompanying a traumatic brain injury.
Once an injured worker exhibits some of the above signs of a mild TBI, imaging can be useful in confirming a TBI diagnosis, especially when the injury is a blunt force trauma with obvious contusions or hematomas easily seen on the MRI. However, doctors frequently rely on a neuropsychological examination to diagnose a traumatic brain injury, even when brain imaging is negative.
A neuropsychological exam is a comprehensive assessment of cognitive and behavioral functions administered using a set of standardized tests. The battery of tests can vary depending on which doctor you see. Because a traumatic brain injury is a functional injury, the Medical Disability Advisor notes that observing the patient’s actual functional limitations, both at injury and throughout the recovery process, offers a more reliable assessment of the actual extent of brain injury. For this reason, a neuropsychological exam is a useful diagnostic tool to formally assess brain function and impairment. The Official Disability Guidelines recommends obtaining a neuropsychological assessment, in addition to imaging, to make an initial brain injury diagnosis.
Adhering to these practices when diagnosing a concussion or brain injury can help to establish your extent of injury in a Texas workers’ comp hearing. These tests are also used to assess any permanent impairment when a doctor assigns an impairment rating after maximum medical improvement is achieved.
Conclusion
If you have a head injury after a workplace accident, it is important to get to a doctor immediately so that your symptoms can be documented. Research shows that your symptoms and how they affect your ability to think and do tasks that you used to be able to do are the best tools to determine what the proper diagnosis should be. In fact, that evidence is much more important than a CT scan or an MRI report when trying to prove your injury before the Division of Workers’ Compensation.
