Brain Injuries in Worker's Compensation Cases
We have another treat from Karen Shelton today.
As a Legal Nurse Consultant working with Steinberg Law Firm, in Charleston, South Carolina, I am often asked to review a case for medical merit. I have been surprised at how many cases involve mild, acquired brain injury and cognitive dysfunction. But usually, the diagnosis of brain injury does not just pop out. There are hidden clues and signs that suggest the possibility.
We all recognize those brain injuries involving skull fractures, unconsciousness, bleeding into the brain, etc. But what are some other examples that you would not ordinarily think of?
How about brain injury from the effects of chemotherapy?How about brain injury from aggravated Chiari I Malformation?
How about brain injury from radiation exposure?
How about brain injury from increased hemoglobin?
How about brain injury from exacerbation of multiple sclerosis?
How about brain injury connected with brachial plexus injuries?
How about brain injury from mold and chemical exposures?
And, of course, there are many cases of minor trauma to the head with no loss of consciousness, but the client begins to display behaviors and personality changes that indicate brain involvement. Think about your clients: how many miss appointments with you or their doctors, how many of them have anger or other personality changes, how many of them experience falls and balance problems or are sensitive to light, how many of them forget things-have you talked to them about these issues? Or better yet, have you talked to their wives or girlfriends?
Recognizing you may have a brain injured client is the first step. Getting the case beyond the possibility into a settled one is the hard part.
On June 13th I was the victim of an automobile accident which occurred as I was traveling home from a visit with a client; I am a case manager nurse and certified life care planner. I was hit on all three sides of my Ford Exployer when an 18 wheeler truck jack-knived. I have been diagnosis with a closed head injury. My symptoms: difficulty expressing myself with language, sleep disturbances,mood changes, short term memory loss.I am having a difficult time with doing ADL which always required multi-tasking.My hope is to be "my normal" again. Jan
Thought I would update on my symtomology since I am now 10 mos. post closed head injury. My short term memory has not changed; I suffer from adrenal insufficiency and therefore am fatigued a great deal; I am medicated for the sleep disorder;I have lost some of my language usage as well as math concepts. There appears to be a breakdown at the Broco's area since my injury is Left temporal and frontal lobes. I am at MMI per my neurologist. Thanks, Jan Dover, RN, CLCP
I have the same difficulties and some. Under normal stress I do okay but any high stress my brain runs away on me. I can only do one thing at a time. I find under high stress I am unable to hear what I am being asked but have to repeat to myself same question; mull it over and than give answer. I cannot hear too many things at once; because I can only take in one thing at a time. If too much is thrown at me at once I get overwelmed. I forget appts. I have to go to great lenghts to make sure I remember things. Post it's , Frigerator, calendar repeat to myself over and over do the three R's etc. If I don't get challenged or think about it I am okay. When I did a memory test reevalution recently the REALITY of my loss of memory makes me very sad.
