WHY THE DELAY IN TRAUMATIC BRAIN INJURY SYMPTOM REPORTING?
Common tactics insurance companies use to deny or undervalue personal injury claims include delayed reporting of symptom/injury development or a delay in seeking out medical treatment. There are likely medically justifiable reasons for these delays in traumatic brain injuries.
Medical literature shows it is not uncommon for a patient to underreport cognitive impairment and behavioral changes in the days, weeks, or even months after a traumatic brain injury. In fact, patients can be so confused by mild traumatic brain injury (MTBI) symptoms that they do not report them to their healthcare professionals. There is excellent evidence in the literature that both patients and doctors may misconstrue MTBI symptoms, and patients often underreport symptoms as the symptoms are foreign to them.
Medical literature supports late-onset symptoms such as problems with concentration, memory, irritability, depression, anxiety, fatigue, and poor judgment. The UPFONT study showed that ten percent of patients with MBTI reported zero complaints two weeks after injury. However, over half of these patients developed complaints at a later stage, leading to less favorable outcomes and lower quality of life one year after injury.[1]
Q: Is a traumatic brain injury an isolated event?
Think again! Traumatic brain injuries should not be viewed as the final outcome of an injury but rather as the beginning of a chronic disease process. TBI impacts multiple organ systems, is “disease causative and disease accelerative, and as such, should be paid for and managed on a par with other diseases.”[2]
Q: Does the absence of CT abnormalities mean the absence of TBI?
No! Although they are the imaging of choice in the emergency department, CT scans may not capture the structural damage in a traumatic brain injury and are thus limited in explaining the severity of the clinical condition. Advanced MRI can identify additional injuries not detectable by visual inspection of standard clinical MR images.[3]
[1] M.E. De Koning, M.E Scheenen, H.J. Van Der Horn, J.M. Spikman & J. Van Der Naalt (2018) From ‘miserable minority’ to the ‘fortunate few’: the other end of the mild traumatic brain injury spectrum, Brain Injury, 32:5, 540-543, DOI: 10.1080/02699052.2018.1431844
[2] Masel, B. Conceptualizing Brain Injury as a Chronic Disease. Vienna, VA: Brain Injury Association of America, 2009.
[3] Maas, A. I. R., Menon, D. K., Manley, G. T., Abrams, M., Åkerlund, C., Andelic, N., Aries, M., Bashford, T., Bell, M. J., Bodien, Y. G., Brett, B. L., Büki, A., Chesnut, R. M., Citerio, G., Clark, D., Clasby, B., Cooper, D. J., Czeiter, E., Czosnyka, M., Dams-O’Connor, K., … InTBIR Participants and Investigators (2022). Traumatic brain injury: progress and challenges in prevention, clinical care, and research. The Lancet. Neurology, 21(11), 1004–1060. https://doi.org/10.1016/S1474-4422(22)00309-X