Traumatic Brain Injury (TBI)
Traumatic Brain Injuries Are Invisible, Permanent, and Massively Undervalued by Insurance Companies
A traumatic brain injury doesn't always show up on an MRI. It doesn't always involve unconsciousness or a visible wound. But its effects are devastating and lifelong: memory loss, personality changes, difficulty concentrating, emotional volatility, chronic headaches, sleep disorders, depression, and an inability to work at pre-injury capacity. Insurance companies exploit this invisibility by arguing the injury isn't as severe as claimed, that symptoms are exaggerated, or that they preexisted the accident. Fighting that narrative requires medical evidence, neuropsychological testing, and an attorney who understands how brain injuries actually present.
At Koussan Law, I've represented TBI victims whose lives were permanently altered by car accidents, falls, assaults, and defective products. The gap between what insurance companies offer on TBI cases and what these cases are actually worth is enormous — because quantifying a brain injury requires expertise that most attorneys and most insurance adjusters simply don't have.
How TBIs Are Classified and Diagnosed
The Glasgow Coma Scale (GCS) classifies TBIs by severity at the time of injury: mild (GCS 13-15, including concussions), moderate (GCS 9-12), and severe (GCS 3-8). But the initial GCS score doesn't always predict long-term outcomes. I've represented clients with "mild" TBIs who still couldn't return to work two years later because of persistent post-concussion syndrome — cognitive fog, headaches, and emotional dysregulation that disrupted every aspect of their daily lives.
Diagnosis involves a combination of imaging (CT, MRI, and in some cases DTI — diffusion tensor imaging, which can detect damage to white matter tracts that conventional MRI misses), neuropsychological testing (standardized tests measuring memory, attention, executive function, processing speed), and clinical evaluation.
Why TBI Cases Are Undervalued
Insurance companies undervalue TBI claims for a simple reason: if the injury isn't visible on a scan, they argue it doesn't exist. They'll point to a "normal" MRI and claim the plaintiff is exaggerating. They'll hire defense neuropsychologists who administer effort testing designed to suggest the patient isn't trying. They'll argue that pre-existing conditions — stress, depression, prior concussions — explain the symptoms. Defeating these tactics requires a neurologist or neuropsychologist who can explain the limitations of conventional imaging, document the deficits through validated testing, and connect those deficits to the accident through differential diagnosis.
Frequently Asked Questions
Q: What are the long-term effects of a traumatic brain injury?
Long-term effects vary by severity but commonly include chronic headaches, memory impairment, difficulty with concentration and multitasking, personality and mood changes, sleep disturbances, light and noise sensitivity, and reduced processing speed. Severe TBIs can result in permanent cognitive disability, inability to work, and need for lifelong assisted care. Even "mild" TBIs can produce persistent symptoms that fundamentally change a person's quality of life.
Q: How is a TBI case valued?
Past and future medical expenses including neurology, neuropsychology, rehabilitation, and medication. Lost wages and lost future earning capacity — often the largest component for working-age adults whose cognitive impairment prevents them from returning to their pre-injury career. Future care needs including cognitive rehabilitation and potentially assisted living. Non-economic damages for pain and suffering, loss of enjoyment of life, and the profound impact on relationships and independence. I retain vocational economists and life care planners to project these costs across the client's lifetime.
Q: What if my MRI is normal but I still have symptoms?
A normal MRI does not rule out a TBI. Conventional MRI detects structural abnormalities like bleeding or bruising, but it cannot detect diffuse axonal injury — microscopic damage to nerve fibers that disrupts brain function. Advanced imaging like DTI and neuropsychological testing are essential for documenting these injuries. I work with neurologists who specialize in TBI diagnosis and can explain to a jury why a normal scan doesn't mean a normal brain.
Q: What is the statute of limitations for a TBI claim in Michigan?
Three years from the date of injury under MCL § 600.5805. For TBI claims arising from auto accidents, PIP benefits have a one-year deadline from each expense under MCL § 500.3145. If a government entity caused or contributed to the injury, the 120-day notice requirement under MCL § 691.1404 applies. Given the complexity of TBI cases and the need for extensive medical documentation, I recommend contacting an attorney as soon as possible after the injury.
