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Winning a Traumatic Brain Injury Case

Winning a Traumatic Brain Injury Case. Using Lay Witness Illustrations New Laws Practice Pointers Imaging Neuropsychologist. Presented by: Richard H. Adler Attorney at Law Adler Giersch PS. I. Magnitude of the Problem. II. Using Before and After Witnesses.

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Winning a Traumatic Brain Injury Case

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  1. Winning a Traumatic Brain Injury Case Using Lay Witness Illustrations New Laws Practice Pointers Imaging Neuropsychologist Presented by:Richard H. AdlerAttorney at LawAdler Giersch PS

  2. I. Magnitude of the Problem

  3. II. Using Before and After Witnesses

  4. 1. Top Reasons to use Before/After Lay Witnesses

  5. 2. When to Obtain Before and After Lay Witness Statements

  6. 3. Who are Good, Qualified Before and After Witnesses?

  7. 4. Effectively Communicating with Before and After Witnesses

  8. 5. Some Examples of Open-Ended Questions for Lay Witnesses

  9. III. New Law

  10. 1. HB 2055 Effective 07/22/07

  11. 2. Lystedt Law

  12. IV. Illustrations and TBI Cases

  13. V. Ethnical Concerns in Handling Traumatic Brain Injury Cases: Knowledge Skill, Thoroughness and Preparation

  14. “Rule 1.1 COMPETENCE A lawyer’s shall provide competent representation to a client. Competent representation requires the legal knowledge, skill, thoroughness, and preparation reasonably necessary for the representation.” Rules of Professional Conduct (RPC) page 223

  15. VI. Effectively Challenge the “No LOC” (loss of consciousness) Dilemma

  16. VII. Initial Considerations on Handling A TBI Case Liability Training and Dispatching an Investigator Assess Your Client Develop Theme of Pre TBI vs. Post TBI

  17. Change Your Thinking • Mild does not mean minor • Mild-moderate-severe-continuum • Is it possible to have mild neurological injury and: • Mild functional impairment? Yes • Moderate functional impairment? Yes • Severe functional impairment? Yes

  18. VIII. Acceleration-Deceleration Forces and Impact on Grey/White Matter

  19. A. Head and brain in neutral position prior to impact B. Initial impact from behind causing front of brain to impact anterior aspect of skull.

  20. A. The contre-coup injury to the brain occurs when the brain strikes the skull on the opposite side of impact. Once the skull has stopped moving the brain continues striking the front of the skull.B. The coup injury to the brain occurs when the brain strikes the skull on the opposing side of impact.

  21. Other Considerations to think about in understanding the role of acceleration-deceleration injuries with TBI

  22. Hard tissue (bone) breaks and does not tear; soft tissue (cell, tissue, ligament, disc) tears, but does not break. The white matter of the brain is closest to the center. Grey and white matter in the brain have different “inertia” variables.

  23. Cont’d The frontal and temporal lobes of the brain, the major speech and language areas, often receive the most damage because they sit in pockets of the skull that allow more room for the brain to shift and sustain injury. During rapid acceleration and deceleration, the effect of centrifugal force may result in tissue tear hemorrhages (small tears of the white matter).

  24. Cont’d Tearing or shearing injuries may take place at the time of the initial injury or it may take as long as 24 to 48 hours for the process to be completed. Nerves and tissues, when pulled or stretched in a slow manner, can oftentimes result in no injury. Injuries are diffuse throughout the brain and not focal or centralized

  25. Cont’d The structure of a brain cell contains synapses. At the end of the connectors are neurotransmitters. Cranial nerves travel through the holes in the skull bone.

  26. IX. Excitotoxicity Injuries

  27. X. Responding to the Negative MRI/CTs: Normal Brain Structure Does Not Mean Normal Brain Fracture

  28. XI. Rebutting the “Normal” Neurological Exam by the IME/DME Neurologist

  29. XII. Effectively Communicating with your Neuropsychologist Questions to ask your neuropsychologist Neuropsychologists find it useful to have all school records

  30. XIII. Neuropsychological Assessments for Traumatic Brain Injury Executive Function Language Skills Verbal Memory Attention Organizational Efficiency, Visual-Motor Memory and Retention of Motion Information Sensory-Motor Emotional Status

  31. XIV. Responding to the “Malingering” Label

  32. Richard H. AdlerAttorney at LawAdler Giersch PS333 Taylor Ave N.Seattle, WA206.682.0300radler@adlergiersch.comwww.adlergiersch.com

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