Mild Traumatic Brain Injuries

Insurance companies will often claim that a person who has sustained a traumatic brain injury doesn’t have a brain injury in a legal claim. The insurance doctors they hire will say that the “mild” designation means that 100% of these TBI survivors have no permanent consequences. Neither of these are true. It is important that a brain injury lawyer understands how to address these issues with the insurance adjustor, defense doctors and the jury. Our extensive experience in this area is why in addition to handling our own brain injury cases, we are hired by other lawyers in Oregon, Washington and other states to bring our expertise and trial skills to their traumatic brain injury cases.

Approximately 80% of all traumatic brain injuries are defined as “mild” even though the symptoms from a “mild traumatic brain injury” may not be mild at all, and can permanently alter a person’s life. They are also the cases fought most vigorously by the insurance industry because by definition MRIs and CTs are negative. Mild traumatic brain injury cases also often do not have a loss of consciousness or a head strike. A lack of head strike or loss of consciousness does not mean that there was no traumatic brain injury, because no current medical definition requires a head strike or a loss of consciousness in order to cause a brain injury. (In fact, recent studies suggest that a person need not even have a “concussion” in order to have permanent brain trauma, but that cumulative trauma to the brain is what results in long term cognitive and neurodegenerative changes such as CTE and Alzheimers.)

There are only three medical classifications of traumatic brain injury; mild, moderate and severe. We have successfully handled cases for people with mild, moderate and severe brain injuries.

There are very specific definitions of mild traumatic brain injury in the medical literature. These come from medical association “consensus statements” going back to the early 90s that provide exact diagnostic criteria of a mild traumatic brain injury. One of the most common definitions of mild traumatic brain injury used in the United States is from the American Academy of Neurology. It is important to notice whether a defense neurologist hired by the insurance company to defend a brain injury claim, follows the American Academy of Neurology definitions. Defense expert testimony in our cases suggest that insurance defense doctors intentionally disregard the standardized diagnostic criteria in hopes that the plaintiff lawyer isn’t smart enough to know the correct criteria, or that the jury will be mislead into believing them. Insurance doctors are paid to sell doubt to the jury. A traumatic brain injury lawyer must understand every attack on this diagnosis and combat it with the correct definitions and medical literature (to the extent the trial court allows it in cross examination.)

A Grade 1 mild traumatic brain injury under the American Academy of Neurology criterial is no loss of consciousness, with transient confusion, and some concussion symptoms or mental status abnormality, and the Glasgow Coma Score is between 13 and 15. 15 is the best Glasgow Coma Score possible. This presentation after a traumatic event still qualifies as a traumatic brain injury.

A Grade 2 mild traumatic brain injury under the American Academy of Neurology criteria would involve, again, no loss of consciousness, some transient confusion, and some abnormal mental status for over 15 minutes.

A Grade 3, the highest grade of “mild traumatic brain injury,” is one with any loss of consciousness at all. And so if you lost consciousness during your traumatic brain injury, the American Academy of Neurology diagnostic definition says you had a Grade 3 mild traumatic brain injury.

It is important to note that even though the medical definitions of mild, moderate and severe are based upon historical findings of Glasgow Coma Scale scores of a certain number, and whether there is the presence of a frank bleed or not, the loss of consciousness can influence the designation to some degree, because of course if you have a long loss of consciousness or automatically go into a coma, you would be considered to have a “severe” traumatic brain injury.

But, the important thing to note here is that with mild traumatic brain injuries you can have severe symptomatic consequences. So the fact that it’s considered mild under the standard definition does not mean that your symptoms will be mild, and in fact, we’ve represented many people with mild traumatic brain injuries that have ended their careers as doctors, other professionals, and certainly as lay people.

If you are seeking a traumatic brain injury lawyer to handle your brain injury case, please visit our web site at or call our office at (503) 227-1233 for a free consultation.

About the

Aaron DeShaw is a personal injury lawyer at DeShaw Trial Lawyers, a law firm representing injured people with serious injuries including brain injuries and other catastrophic injuries. He has individually, and in association with other law firms, obtained over $1 Billion for his clients. Learn more about Aaron and the Firm.