how to explain a brain injury disability

Survivors have difficulty planning which is known as impaired executive function. Many students who sustain brain injuries have resulting specific learning disabilities (SLDs). Survivors suffering moderate to severe injuries will have hospital and rehabilitation care from a wide range of professionals. Level I: no response to pain, touch, sound or sight. Impaired communication skills, such as aphasia, the inability to understand or recall the simplest words, is caused by brain cell damage, not by physical inability to speak. Level II: generalize reflex response to pain. Survivors experience spasticity or abnormal tone and muscle stiffness. A Social Security disability attorney can offer you legal advice regarding whether you are likely to qualify for disability benefits. But TBI is different. A brain injury that happens later in life usually has different symptoms than CVI, which is caused by an injury early in life. Post-concussion syndrome; Almost 50 percent of victims of TBI experience post-concussion syndrome (PCS) within a few days of the injury. The educational therapist teaches the basic skills needed to return to school or work and arranges for a special educational environment from designing course work that will develop reading, writing or math skills to arranging for note takers or real time court reporters in class. Earning more than $1,170 a month as an employee is enough to be disqualified from receiving Social Security disability benefits. Learn more about head and brain injury disabilities from America's top disability firm. Survivors of TBI face monumental challenges to job re-entry and having realistic expectations are important from the outset. TBI is considered a form of acquired brain injury, and refers to brain damage caused by an impact to the head. Traumatic brain injury is listed under neurological disorders. Dealing with abstract concepts as literal facts is additionally confusing. Such a misinformed view by a treating physician severely impacted the plaintiff s ability to achieve fair compensation in a strongly contested case of liability. Before October 2016, Social Security evaluated traumatic brain injury under disability listings for other types of medical conditions: stroke, epilepsy, or organic mental disorders (called neurocognitive disorders). Consciousness remains intact and often is viewed as a loss of concentration. Neurologic damage readily disrupts how a person thinks and processes information. Some of the physical consequences that may occur after a brain injury include decreased muscle control, paralysis, weakness, seizures, sensory losses, and difficulty speaking or swallowing. A traumatic brain injury (TBI) is the result of an external force injuring the brain. Please try again. About Traumatic Brain Injury. Ask if the traumatic brain injury disability meets or equals a medical listing. How to Obtain Disability Benefits for a Traumatic Brain Injury Posted on behalf of Dayes Law Firm PC on Mar 05, 2018 in Qualifying Conditions March is Brain Injury Awareness Month, which makes it a perfect time to think about the impact of traumatic brain injuries and what benefits may be available for individuals who suffer from this condition. News. Throughout this discussion the TBI survivor has been presumed to be an adult. The term is used to refer to individual functioning, including physical impairment, sensory impairment, cognitive impairment, intellectual impairment mental illness, and various types of chronic disease. The lowest score is a 3 and indicates no response from the patient. If the student had an SLD before the brain injury, it is possible that the learning disorder may worsen. You may be unable to communicate effectively, you may lose mobility, and you may not be able to lift, carry, or grasp things. Those who show concern and attention can be viewed as being angry toward the survivor. To determine the level of vocational functioning the counsellor also evaluates the patients ability to follow instructions and social skills. By mastering a thorough understanding of TBI the legal professional takes the first step towards providing both judge and jury with the knowledge necessary to understand, appreciate and provide for appropriate care for the traumatically brain injured. Regular encouragement and visual cues are helpful in prompting initiation. This often results in swelling and resulting compression that can have long term effects. Get started by taking our free SSDI Assessment to determine your likelihood of qualifying. Most common types of disabilities caused by TBI. We’ll explain the types, what they look like, and what the outlook may be. McKinney, Texas –If Gloria Barotta had her way, she might wear a bandage on her head to show something is wrong with her…. As a trial lawyer you must be alert to the full range of TBI symptoms. Studying and understanding the treatment of the severely injured will assist in identifying the needs of the person who has suffered mild head injury. From a public health perspective, alcohol abuse training, roll bars, air bags, and helmet protection for motorcyclists, bicyclists, skateboarders, and skiers are top priorities because the number of TBI survivors is not expected to significantly diminish over the next ten years. An estimated 13.5 million individuals live with a disability due to traumatic brain injury in the U.S. alone. If the person cannot, then the process proceeds to the fifth and final step. Double vision, loss of depth perception, and an inability to see on one side of the body can occur. Testing helps determine the survivors ability to learn, to make judgments and to evaluate productivity, punctuality, reaction time, distractibility and tolerance for frustration. A person who has a medically determinable severe impairment of traumatic brain injury and is unable to understand, remember or carry out simple instructions would be found disabled based on his/her mental residual function capacity. Maximizing damages for these plaintiffs requires a thorough understanding of traumatic brain injury. Anterograde amnesia is the inability to recall events that have occurred since injury. There is no question that much violent crime can be traced to brain injury, especially in criminals who are repeatedly violent. Therefore, the mental findings immediately following TBI may not reflect the actual severity of your mental impairment (s). Additional Resources. It is the patient with mild injuries with a complete medical recovery from physical symptoms that presents a major challenge to the skill of treating physicians, rehabilitation professionals, and to the legal team called upon to prove and explain the long term effect of these injuries to judges and juries. Head injuries bring more than 400,000 people to hospitals every year. Gross attention to environment, highly distractible, requires continual redirection, difficulty learning new tasks, agitated by too much stimulation. At the same time, not surprisingly, a nationwide survey has ranked California 31st among the states in the delivery of mental health services, a further decline form its 25th place two years ago. The ADA does not contain a list of medical conditions that constitute disabilities. Read how one person’s journey to approval was made easier with True Help. The range and severity of disabilities in one patient will vary dramatically. Grant is an internationally recognized brain injury advocate, freelance writer, keynote speaker and brain injury survivor based out of southern New Hampshire. A brain injury may also impair the student’s ability to retrieve information when needed, even though the student otherwise remembers the information. Even then they can be readily forgotten, with accompanying frustration, depression, and anger. TBI patients without families or financial protection are relegated to the street or incorrectly diagnosed as mentally ill. For those with families, the families do not simply become care providers: they suffer an outrageous burdens that destroys families, causes siblings to leave home prematurely, and mandates that someone give up their life to care for the injured. You or they can call us at (800) 279-4357 to get started. If your friend hires Allsup and we process an SSDI application for them, you’ll receive $100. Microsoft Edge. I have learned more than I realised from my visit to a Stroke Support Group along with the thought- provoking comments received after writing the visit up in last weeks blog.From all this new questions arose, in particular more about invisible disability, or hidden disability after brain injury.I have been using the term hidden disability after brain injury for many, many years and this week I realised it has become a kind of automatic phrase – till no… If you have suffered a traumatic brain injury (TBI), you may be able to receive disability benefits through Social Security Disability Insurance (SSDI) and/or Supplemental Security Income (SSI). Level VI: confused/appropriate. He is the author of Metamorphosis, Surviving Brain Injury, a book that chronicles in the first year-and-a-half of his new life as a brain injury … Attention and concentration is something most of us do well. Those who suffer skull fractures, loss of consciousness and coma and typically are diagnosed as moderate to severe injuries, with obvious physical impairments. Injuries occur when the momentum of the brain impacts against a skull that has been decelerated. In tandem with the pediatric neurologist is the research psychologist who can educate the trier of fact concerning the long-term effects of head injury, the impact on the family, the need for lifecare planning, and the most common sequelae for TBI survivors. Physical therapists focus on restoring motor function, strengthening muscles, improving coordination, balance, endurance and the movement of joints. Social Security Rulings 85-15 and SSR 96-9p both describe how an individual must, on a sustained basis, be able to understand, remember and carry out simple instructions; make simple work-related decisions; respond appropriately to supervision, co-workers, usual work situations and to deal with changes in a routine work setting. It is important for the patient s legal representatives to have a strong and responsible working relationship with the social worker. The severely handicapped TBI survivor presents the easier case for maximizing damages because the extent of the injury is not doubted. Ask if the traumatic brain injury disability meets or equals a medical listing. Because the family will be in regular contact with the social worker, they will seek advice and will share confidences with the social worker. Social workers provide the important connection between the health care staff, rehabilitation professionals, family, school, work and often the insurance carrier funding the rehabilitation. A second category of seizures are known as focal motor or partial seizures which present as jerking movements or twitching. A disability is defined as a condition or function judged to be significantly impaired relative to the usual standard of an individual or group. There are many different definitions of Acquired Brain Injury - the “acquired” bit refers to any damage to the brain that occurs after birth, and is meant to differentiate brain injury from congenital disabilities like intellectual disability - and, doubtless, none of them are perfect in, for example, what conditions or diseases they include or exclude. For example: Ask if the traumatic brain injury disability meets or equals a medical listing. By the same token, developing maturity also masks the recovery process and leaves the question whether the youngster is recovering or developing. The physiatrist combines physical medicine and rehabilitation medicine dir ected at renewing function and these medical doctors are trained in both neurology and orthopedics. Level V confused/non-agitated. Occupational therapists provide rehabilitation skills to help the patient perform physical tasks involving both gross and fine motor skills, as well as performing the six activities of daily living: bathing, dressing, toileting, transferring [getting in and out of a chair or bed], continence [voluntary bowel and bladder functions], and feeding. The Rancho Los Amigas Cognitive Scale describes levels of function and are used to assess the efficacy of treatment programs. Learn more about FindLaw’s newsletters, including our terms of use and privacy policy. This can easily be confused with being unmotivated because these patients have difficulty paying attention and are sleepy. There are many possible causes, including a fall, a road accident, tumour and stroke. About brain injury An acquired brain injury (ABI) is an injury caused to the brain since birth. Loss of consciousness, irregular breathing, and loss of bowel and bladder accompany severe shaking. Significant confusion following a head injury is so common that the primary medical inquiry is to establish if the patient is oriented. These are most commonly caused by car accidents, falls and injuries from guns. Pre-existing conditions may be amplified following TBI. Impaired judgment occurs when abstract thinking is impaired. By far the most challenging plaintiff is a child who is attractive and who will walk into the courtroom. Computers are used extensively as a training tool by cognitive therapists. Brain Injury: Proving a Lifetime Disability; Brain Injury: Proving a Lifetime Disability ... and to the legal team called upon to prove and explain the long term effect of these injuries to judges and juries. If a finding of disability still is not possible at that time, adjudication of the claim will again be deferred until evidence is obtained at least 6 months post-injury. Disability is conceptualized as being a multidimensional experience for the person involved. We pay attention and focus on a specific task and block out distractions both internal and external. TBI may result in neurological and mental impairments with a wide variety of posttraumatic symptoms and signs. Short-term memory and recalling what happened yesterday is more common than the loss of recall for older information. Particularly striking was the report's conclusion that 3,600 severely mentally ill inmates housed in Los Angeles County Jails comprise the "largest de facto mental institution in the nation.". The neurologist specializes in the medical treatment of the nervous system: the brain, spinal cord, nerves and muscles. Contact a personal injury lawyer today to discuss your rights. Keep in mind that, unlike common orthopedic injuries, there is no bright line to identify brain injuries and even if there were a line it would not be a straight line. Copyright © 2020, Thomson Reuters. If the SSA finds that a person can do his past work, benefits are denied. Traumatic brain injury can have a significant impact on your life. A substantial loss of ability to meet any one of these basic work-related activities would severely limit the potential occupational base for all age groups and justify a finding of disabled. The neuropsychologist specializes in evaluating brain function and performs sophisticated tests of brain function necessary to identify specific injuries and to select appropriate rehabilitation efforts. Impact with these inner surfaces of the skull causes tearing and bruising that results in brain damage. Traumatic brain injury is listed under neurological disorders. A closely related condition, dysphagia, the inability to swallow and chew properly, can be readily observed when a patient extends his/her neck or engages in some accommodating movement when swallowing. Because they have suffered objective physical injuries, their resulting impairments are readily accepted as having been caused by the initial insult. In 2013, traumatic brain injury was a diagnosis in more than 282,000 hospitalizations and 2.5 million emergency room visits. They are the "go for the gusto," high speed, consumers of alcohol who are going to live forever and who dominate ERs Friday night through Sunday morning and the Monday morning arraignment calendars. Approximately three-quarters are diagnosed as having suffered a mild to moderate injury - injuries that can be subtle, persistent, and potentially long term. Applying a task to a similar but different situation cannot be accomplished. Level VII: automatic/appropriate. For example, if a person with a traumatic brain injury would warrant a finding of disabled at any age. To determine traumatic brain injury disability, the SSA enlists medical-vocational rules, which vary according to age. The causes of an Acquired Brain Injury (ABI) can include falls, stroke, infections, accidents, lack of oxygen and cancer. Learn more about the SSDI approval process for individuals with a Traumatic Brain Injury. Sleep disorders are another area of inquiry. Alert, very active, aggressive or bizarre behaviors, performs motor activities but behavior is non-purposeful, extremely short attention span. | Last updated March 26, 2008. Helping Those with Brain Injuries or Neurological Disorders. Each level of response indicates the degree of brain injury. It is different from an intellectual disability or a mental illness. This research is confirmed by the University of Pennsylvania study of 286 psychiatric patients who showed unprovoked rage; in that cohort 94% had some kind of brain damage. The rehabilitation case manager or rehabilitation specialist coordinates the goals of the patient, family and rehabilitation staff as an advocate for the patient and oversees the overall treatment plan. All of this underscores the critical need for the testimony of the lifecare planner that will identify the services the survivor will require for life, but in addition, the cost of providing on-going care and supervision for a lifetime that will prevent the survivor from suffering additional mistreatment by police, courts and corrections. These survivors need to be reminded and prompted in simple tasks, such as daily care and living tasks. The attractive child with a severe impairment will generate compassion and understanding from his/her environment, but once the adolescent years begin the tasks of dealing with sexual drives, peers, alcohol and drugs in the TBI survivor are grossly complicated. Question: Dr. Bradbury, I read your columns regularly and a couple of times you have written about diagnosing someone with mental retardation, or intellectual disability.If someone experiences a head injury, and the results of testing are in the intellectually deficient range, how do you decide if the diagnosis is a traumatic brain injury or mental retardation? Combinations are likely to be unique to brain injury. Not knowing the day, week, year, where they are or what happened results in the patient asking searching questions. The severity of injuries can vary from mild to severe depending on how serious the causing incident was. Living unsupervised in the community will result in exposure to police and courts, which creates a whole additional range of problems that are important to understand. A neurologist is first called to make an initial evaluation, diagnose the injury and consult on immediate medical care the patient requires. Call 800-458-4577 to schedule a free consultation with DarrasLaw. There is widespread misunderstanding concerning traumatic brain injury even in otherwise knowledgeable medical circles. Blinks to strong light, turns toward or away from sound, responds to physical discomfort, inconsistent response to commands. Seizures can occur immediately or may be delayed until months or even years after the initial trauma. In cases of moderate to severe damage, seizures, coma, impaired behavior and thinking, and death may occur. Unfortunately, reassurance should always follow a realistic assessment and often there is not enough time, or insufficient skill, to conduct a proper medical evaluation. The case manager is routinely in charge of reporting to the insurance carrier funding the recovery program. At that time, any neurological and mental impairment is fully evaluated and the claim is adjudicated. Memory, attention, organization, planning and perception are functions disrupted by TBI. To appreciate the extent of a precipitating injury, it is helpful to understand two commonly used medical scales found in every medical chart involving TBI. Fatigue is extremely common in the early stages following injury. People with impaired memory may remember and retain old skills, but learning new ones require repeated instructions and extended practice. Once the evaluation is completed a specialized training program is designed and implemented to promote a smooth transition to being able to once again be gainfully employed. Explore the ability of an individual to perform work they have done in the past despite their traumatic brain injury. Since the medical community generally speaking is not well trained in neurobehavior, physicians often fail to diagnose the short-term and potentially chronic aspects of closed head injuries in the regular office visit. A traumatic brain injury (TBI), also known as an intracranial injury, is an injury to the brain caused by an external force. A serious brain injury can leave you unable to care for yourself and unable to work. empower is a personalized online tool that guides you through the application process and can help you use these benefits to return to work, if and when you medically recover. As this child matures it is extremely common for more serious behavioral and learning disabilities to emerge, which further compound the development of personality, attitudes and life-coping skills. The goal is to help survivors identify techniques to improve their ability to remember ideas. Poor balance, decreased endurance, loss of the ability to plan movements of arms, legs and poor coordination are evident. This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply. Causes of acquired brain injury. Level III: localized response to pain. Even after he reviewed well documented medical references describing fatigue as the most common complaint in two-thirds of all minimal to moderate head injury patients, this physician still opined that his patient s fatigue was secondary to depression and unrelated to injury. There … ABIs can happen to people of all ages at any time and can cause temporary or permanent effects. In fact, brain injury can alter a person’s entire cognitive process. An ABI can be caused by: Traumatic brain injury symptoms can vary widely depending on the type and severity of the injury and the area of the brain affected. People with concussions heal over time and that many of the emotional conditions reported can be equally associated with psychological conditions which occur in the absence of physical trauma. Total reversals of sleep patterns, the need for multiple naps and rest periods and loss of bowel and bladder control are reported. If a finding of disability within 3 months post-injury is not possible based on any neurological impairment (s), adjudication of the claim will be deferred until evidence is obtained of your neurological or mental impairments at least 3 months post-injury. Often, the general term “head injury,” which refers to a broader class of injury that can involve impairment in structures like the skull and scalp, is used synonymously with traumatic brain injury. If a TBI has left you disabled, you can start your disability application with the SSA. The combined effects of brain injury, from the different parts of the brain damaged may create extra or different problems. Nerve fibers are sheared in rotational injuries that can leave the brain stem permanently altered. Lost motor control or weakness of one arm or leg or on one side of the body is known as hemiparesis. Disability Benefits for Traumatic Brain Injury . Internet Explorer 11 is no longer supported. The slightest distraction causes a complete loss of concentration and results in confusion. In this setting, reassurance goes a long way to promote healing and well-being. Know someone who needs help? In addition to physical consequences of TBI the ability to understand feelings and the ability to control emotions are impacted. TBI affects the roots of who we are — our ability to think, to communicate, and to connect with other people. Skills noticeably deteriorate in unfamiliar environment. These patients are told they will recover. David A. Speech disorders follow damage to the cranial nerve which enervates the face. Tips on Applying for Disability Benefits with a Traumatic Brain Injury. If you or a loved one has vision problems because of a brain injury, ask the doctor about vision rehabilitation and other support services. Post-concussion syndrome presents with headaches, spasticity, dizziness, reduced coordination, sensory dysfunction, memory losses, problems in concentrating, difficulty in perceiving, sequencing, judgment and communication, fatigue, loss of empathy, depression, anxiety, sexual dysfunction, depressed motivation, emotional volatility, slowed thinking and impaired writing and reading skill. Then explain any adjustments you would need the company to make and end by saying you're available to discuss if they have any questions. The social worker s background study is one of the most significant documents in the rehabilitation chart. The actual severity of a mental impairment may not become apparent until 6 months post-injury. At the criminal justice level, next to nobody, including public defenders and judges, appreciates that TBI has been closely associated with criminal histories and specifically with violent rages. As a result many do not receive appropriate care and treatment for the disabilities that follow, including physical, cognitive, psychological, and social impairments. Coping with confusion is extremely frustrating and leads to more confusion. Neurological and cognitive disability includes acquired disability such as multiple sclerosis or traumatic brain injury. Determine if an individual is working (engaging in substantial gainful activity) according to the SSA definition. After regaining consciousness, the patient reports soreness and confusion. Now, TBI has its own listing in Social Security's listing of impairments (called the "blue book"). You can file the application online at or get started by calling 1-800-772-1213. Vocational rehabilitation counsellors identify skills, aptitudes, and abilities that will help restore the patient to the world of work. Head injuries are one of the most common causes of disability and death in adults. Respiratory or pulmonary therapists help the patient breathe and maintain a ventilator employed to insure clear airways. Because speech deficits are the most common disability for survivors, speech pathologists are involved in evaluating and teaching speech, writing, reading and expression skills aimed at both comprehension and communication. The type and severity of the disability depend on the seriousness of the injury and the part of the brain affected. The most challenging aspect of representing TBI survivors is that many times they suffer minimal outward physical manifestations of injury. A whole range of behavioral symptoms occur with TBI: agitation, depression, frustration, rapid changes in emotion and severe mood changes, insensitivity to others, self-centeredness, rage tantrums, poor impulse control, loss of inhibition, decreased libido, inappropriate sexual expression and loss of self-esteem. Medically these injuries are distinct from hypoxic injuries caused by reduced oxygen. May engage in social conversation but with inappropriate verbalization. The most significant hurdle to learning after injury is memory loss and impairment. Loss of sensation to parts of the body and hypersensitivity are also common. Survivors who have difficulty understanding are diagnosed with receptive aphasia. Current research from the University of Chicago by Dr. Stuart Yudofsky shows that the most common cause of explosive anger is brain injury or neurological disease and that there are now medications available to control violent rage. The inability to meet any of the basic mental demands of work would entitle a claimant to disability benefits. Traumatic brain injury, or TBI, is a term referring to any serious head injury that causes damage to the brain. Social Security Disability for Traumatic Brain Injury. The human brain consists of billions of microscopic fibers, suspended in cerebrospinal fluid. Attorneys are often the first professionals who take the time to listen carefully to the patient, who critically evaluate any lingering condition, or carefully observe symptoms. Conclude the traumatic brain injury disability must be severe enough to significantly limit one’s ability to perform basic work activities needed to do most jobs. Review age, education, work experience and physical/mental condition to determine what other work, if any, the person can perform. We recommend using Dysarthria, difficulty in pronouncing words, characterized by slurred or slow speech or loss of the ability to vocalize, results from weak muscles or reduced coordination of the muscles required to produce speech. A pediatric neurologist is invaluable in explaining how injury interrupts growth and development and why children need specialized rehabilitation services now and in the future. Families members accompanying the plaintiff are excellent resources who can describe changes in personality, skills and the subtle symptoms and complaints many times dismissed as the complaints of a hypochondriac. Traumatic Brain Injury and Social Security Disability; How the Blue Book Can Help You with Your Traumatic Brain Injury SSD Claim Anecdotes do not replace scientific evidence, bur recently a well regarded neurologist, an assistant clinical professor of medicine at Stanford University and a respected scientist and author, concluded that a moderate head injury in a bicycle/truck collision, in which the plaintiff's bicycle helmet was fractured, was not responsible for chronic fatigue six months post-injury. Respiratory obstructions and compromised lung function that cause a total cessation of oxygenation result in anoxic injuries. Aphorisms, such as a complimentary "you are a tough cookie," are interpreted to mean that the listener is a piece of food that is extremely hard to chew. A person who is alert and oriented would be rated at 15. On this page, we discuss how both the Social Security Disability and SSI programs evaluate TBI, or traumatic brain injury, as an impairment, with a focus on how the Social Security list of impairments, or blue book, gives consideration to this condition. The mind s capacity to receive, store and retrieve information is effected. Reports of choking or the need to soften food with water before swallowing are significant. Estimated annual direct and indirect TBI costs are $76.5 billion. Approximately 5.3 million Americans are living with a TBI-related disability. Without attention and concentration, learning cannot occur. The guidelines for evaluating impairments caused by cerebral trauma are contained in 11.18, which states that cerebral trauma is to be evaluated under 11.02, 11.03, 11.04, and 12.02, as applicable. Level IV: confused/agitated. Patients complain of trouble organizing thoughts, inability to express themselves, difficulty selecting and recalling words, short-temper, learning new information and retaining it, getting lost, confusion and agitation.

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