Head Injury

Head injury, acquired brain injury. traumatic brain injury

Care and carers

September 28, 2009 in Compensation, Head Injury, Spinal injury | No comments

For all the best reasons we want to care when a family member is in need.

My experience tells me that carers do not think about the toll the care regime takes on them. You have to be forced to stop and think, particularly because your relationship with the injured person is going to change. For instance a wife becomes a carer, and a serious injury may mean the injured person is no longer the person you married. That is a tough message, but it has to be weighed up when looking at a care regime.

Experience tells us that respite for the carer is vital. We must also look long term, particularly if there is a physical element to the care, such as lifting and wheel chair use. You may not be as fit in ten years time. Much as you want to do everything yourself you must look at the alternatives, and do what is right for you, as well as the injured person.

It is sad to say but I have seen couples divorce after a serious injury, particularly where an acquired brain injury has been suffered, and there are changes in behaviour. The spouse or partner fights for the best treatment and compensation, but that fight together with the stress and strain of full time care, is often too much. I am not surprised relationships break down, and have every sympathy for those in this situation, but these facts of life have to be faced.

The best time to look at these issues is when a care regime is being established. it is here that I strongly advise on the need for an experienced case manager. They will manage the care regime, and make sure all other agencies are playing their part. A case manager can make a real difference as they will bring objectivity to the assessment of needs, including yours as the carer.

For more information see:

Let us know if you come across good sources of information and support.

Child head injury

September 28, 2009 in Case examples, Head Injury | No comments

A young girl was a passenger in the family car which was hit by a lorry.

This case underlines how carefully we must check for an acquired brain injury in a child. Two people died in the accident, and the child seemed to be free of major injury. As time went on the acquired brain injury became more obvious, and was illustrated by the instruction of appropriate experts. An acquired brain injury can often appear to have only subtle effects, but if your ability to remember and organize is affected, the consequences are going to be very serious.

The settlement took account of educational difficulties which would lead to career problems. The compensation was placed in a Personal Injury Trust. This meant means tested State benefits could be claimed, and the compensation could be properly used through the discretion of the Trustees. If a child is injured, any compensation award must be approved by the Court, and the money is usually paid into the Court Funds Office for investment until the child is 18 years of age. Once the child reaches 18 years of age the money is theirs, and is paid out by the Court. Special arrangements can be made if money is required immediately, or as in this case if control is necessary beyond the child’s 18th birthday.

Child acquired head injury

September 28, 2009 in Compensation, Head Injury | No comments

These are difficult personal injury compensation cases and require experience and expertise.

At the outset of such a case much time and effort is spend on the child’s medical, educational and financial needs. The support available varies depending on where you live, but if you do not know what help you are entitled to, where do you start.

Compensation is calculated on the difference the injury has made, we compare the before and after. The calculation is in terms of money, and the most significant areas are the cost of care, and earnings loss or reduction. Much easier to weigh up the consequences for someone injured in their thirties, whose career path is already decided. With a seriously injured child the presentation of the case requires experienced help.

The assessment of the effect of the injury is not as precise or scientific as you might think. It is not easy to look at an eight year old child and predict what their working life will be. That is the question which has to be answered. School records, how are brothers and sisters doing, how were the parents educated, what do the parents do for a living, and how motivated are they in the development of their children, are all questions which have to be answered. This part of the case has to be managed carefully as most evidence against which such assessments are made means the injured child is assessed against the average, or the norm. The assessment must be as specific to the child with the acquired head injury as possible.

Rehabilitation can play a significant part. If the case is straightforward on the question of liability, the third party insurer will often agree to cover the cost of rehabilitation. The insurer will cover this cost in the hope of bringing about an improvement. Insurer’s vary in their approach to rehabilitation. An alternative is to obtain an interim payment, and use that to help with private medical treatment and therapy, to give the injured child the best chance of recovery. In any care regime you need a case manager to bring together home life, education, and treatment.

Advice on children with an acquired brain injury is available from:

Advice for parents and carers is available from:

These are just a few examples. Let us know if there are others we should add to this list.

Tractor turns right

August 17, 2009 in Case examples, Compensation, Head Injury, Motorcycles | No comments

A tractor turning right without indicating as a motorcyclist overtook had serious consequences.

The rider was knocked off his bike and then run over. Many fractures were suffered, together with a head injury. The accident brought to an end a promising military career, and in fact the combination of the physical disability, and more importantly, the head injury, made future employment unlikely.

Receipt of War Pension and an early interim payment allowed for suitable accommodation and transport. Family support was so important in this case.

A significant settlement allowed the purchase and adaptation of a home, and sensible advice meant long term income was protected.

Structured settlements, depending on the annuity rate current at the time of settlement, can produce long term security. All or part of the compensation fund can be used to purchase an income for life. It appears expensive, but when long term care and security is the priority a structured settlement can work well. The income from a structured settlement is received free of tax, and is not taken into account when means-tested State benefits are assessed. These two factors often mean it is a challenge to equal the income of a structured settlement using other investment strategies.

Although not available at the time this case was handled, periodical payments are now available. They are considered so important that in large compensation case you will have to persuade a Judge why periodical payments are not the answer. From the injured person’s point of view you might feel a long term relationship with the Defendant’s insurer is not ideal. You might prefer to be independent. The driving force behind the introduction of periodical payments is the high cost to the NHS of birth damage cases. It helps budgeting to spread the cost of multi million pound settlements over the lifetime of the injured child. The benefit for the claimant is that the periodical payments can go up if circumstances change, but of course down if costs reduce.

There are cases when structured settlements and periodical payments are the best solutions, but there are occasions when they are not. Experienced specialist advice is very necessary in a high value case.

Whilst on the question of compensation and long term needs, one subject to include is the Personal Injury Trust. The law allows compensation from a personal injury settlement or award to be paid into a Personal Injury Trust. The Trust fund and income is ignored when assessing means tested State benefits. Such a trust does not have to be complicated, and the injured person can have control of the fund. A Personal Injury Trust can also be useful when the injured person might need to be protected from investment risk, as others can be appointed as Trustee, and manage the Trust with a long term view. Remember, you only get one compensation award, and when it is spent there is no more, unless you were awarded provisional damages.

Acquired brain injury

August 1, 2009 in Compensation, Explanation, Head Injury | No comments

There are many causes of brain injury. Acquired brain injury is a term which covers all situations in which brain injury has occurred since birth, and includes injury from trauma/injury, as well as tumour, stroke, haemorrhage and encephalitis, as examples.

This post deals with injury caused by accidents, sometimes called traumatic brain injury. You might think the trauma has to be significant, but experience shows what looks like a minor event can cause an injury.

Brain injury is first caused by outside force, but then complications can follow, such as damage caused by lack of oxygen, and rising pressure and swelling in the brain.

The effects are described at different levels of severity using mild, moderate and severe. We find the mild injuries most difficult as the problem is not always spotted early. Medical staff tend to deal with the physical injury but do not spot the acquired brain injury. A minor injury (15 minutes unconscious or 1 hour post trauma memory loss), can mean symptoms including nausea, headaches, dizziness, impaired concentration, memory problems, extreme tiredness, intolerance to light and noise, and can lead to anxiety and depression. Not minor problems really. Help and support is necessary, but of course the problem has to be spotted. Most minor injuries will have recovered within 4 to 6 months.

A moderate injury (up to 6 hours unconscious or up to 24 hours post trauma memory loss) has symptoms including tiredness, headaches and dizziness. Add to these difficulties with thinking, attention, memory planning, organising, concentration and word-finding problems. These symptoms are accompanied by understandable worry and anxiety, leading to anxiety. If the problem is spotted early and the likely effects explained, the path of the injured person can be smoothed. Without that warning every day life can be very difficult. Overall recovery is likely in most cases but may take up to 9 months.

You will appreciate your solicitor must have an understanding and experience of the effects of such an injury. Without that how are we to work together?

You will see from the list below there are organisations whose focus is on children. The treatment of head injuries has a divide based on age. Paediatric departments tend to lose interest beyond the age of sixteen, and the adult services may not be ready to provide the support. There are educational needs which may have to be pursued vigorously if the best outcome is to be achieved. A child is represented through their parents, but as before, an acute awareness of the needs of such an injured child is necessary if the compensation process is to help.

There are some very informative sites of organisations whose main interest is head injury so do learn more at:

Motorcycle v U turning car

July 29, 2009 in Case examples, Head Injury, Motorcycles | No comments

Jack’s was on his way home from work on his Kawasaki ZX9R, his pride and joy. The bike at the time was renowned for being the fastest bike on the road.

He had been travelling up hill on a dual carriageway and was just about to overtake a car on the inside lane when the car  U-turned across him. Jack did his best but hid the car.

What happened next, Jack can only guess. He woke up in hospital on a spinal board. He was told that he had suffered serious fractures and would have to undergo an emergency operation. He spent the following 3 days in Intensive Care. Jack had in fact suffered numerous injuries including post-traumatic amnesia due to a severe head injury, a hangman’s fracture, a fractured elbow, a heavily bruised abdominal wall and a ruptured aorta.

Despite all his injuries Jack made a good and quick recovery, returning to work a few months later. However he was not the same person after the accident.

One of the hardest things for Jack was the fact the crash affected his voice. One of his vocal chords had been paralysed which meant his voice was very weak and quiet. Adding to this his head injury which caused him to pronounce words incorrectly and left him with debilitating migraines life was far from back to normal. Sometimes the less obvious injuries have the greatest long term effect.

To make things worse the driver of the car had been uninsured which meant we had to pursue the case against the Motor Insurers Bureau. They argued that Jack should have been able to stop in time and that he was travelling too fast. This is a consistent argument against motorcyclists. The truth is a motorcycle is not seen, so the driver claims the bike must have been ridden too fast. I did not see you because you were going too fast does not make sense.

Mark Thompson has acted for many motorcyclists over the years. A bike is a great way to travel but do look out for them as the consequences of a collision can be awful.

Head injury – long term effect

July 29, 2009 in Compensation, Head Injury, Motorcycles | No comments

A motorcyclist suffered a catalogue of physical injuries, but most serious long term was a head injury.

The rider was overtaking a tractor which turned right across him, and then ran him over. By establishing the tractor did not indicate, Mark Thompson secured a compensation settlement in excess of £1 million for the motorcyclist.

The defence argued excessive speed, almost an automatic argument when a motorcyclist is involved.

The serious effects meant the rider lost the ability to continue with his career. He required adapted housing and might need long term care if he becomes wheelchair dependent. Add to this an acquired brain injury, and a simple u-turn had very serious consequences. The head injury was important even though the effects were subtle. Such injury can bring about a change in personality, a heightened level of aggression and less inhibition. Judgment is often an issue, and that has to be borne in mind when a large sum in compensation is won.

Mark successfully settled this case using evidence from a range of doctors, employers, former employers, financial and pension advisors.

The settlement allowed for interim payments to be made during the action to allow for the purchase of an appropriate home, and the necessary adaptations, plus an adapted vehicle.

Ultimate settlement provided the motorcyclist with a regular tax free income guaranteed for life (called a structured settlement). The settlement was set up in a Trust to allow state benefits to continue to be paid, despite the large capital sum won in compensation.

It was vital to ensure this man’s future was protected. The after effects of the accident were traumatic, the lawyers job in such a case being to ensure a complete framework for the clients future.

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