Brain Injury Compensation Claims: Guidance for Clients and Families
A brain injury can affect every aspect of your life and support for each stage as you progress with rehabilitation is paramount. Research reveals around 350,000 annual hospital admissions for acquired brain injury. The causes vary, ranging from accidents at work or on the road, to assaults and clinical negligence.
Establishing a Brain Injury
Glasgow Coma Score – Adults
The Glasgow Coma Scale (GCS) assesses the patient’s consciousness level through the patient’s ability to open their eyes, move and speak. The total score is calculated by adding up the scores from the three categories which are classified as:
- Severe: GCS 8 or less
- Moderate: GCS 9 – 12
- Mild: GCS 13 – 15
Paediatric Glasgow Coma Score – Children
GCS is not used with children, especially those who are too young to have reliable language skills. The Paediatric Glasgow Coma Score (PGCS) is a modification of the scale used on adults which still uses the three tests (eye, verbal and motor responses) with a slightly altered grading scale but with the same classification of severity.
Effects of Brain Injury
Physical – Affecting how the body works
- Slowed mobility
- Balance problems
- Stiff / weak limbs – spasticity
- Weakness – hemiparesis
- Paralysis – hemiplegia
- Irregular uncontrolled movement, shaking / clumsiness – ataxia
- Sensory impairment – loss or exaggeration of sensation, eyesight affected
- Fatigue – excessive tiredness with otherwise everyday tasks
- Difficulties with speech
- Hormonal imbalance – mood swings, muscle weakness, fluctuating body weight
- Sexual functioning and wellbeing
These symptoms may affect one side of the body more than the other depending on the side of the brain that is injured (each half of the brain controls the opposite side of the body).
Cognitive – Affecting how the person thinks, learns and remembers
- Problems with short-term memory / working memory
- Language loss – aphasia
- Impairment in visual-perceptual skills
- Reduced initiation and problems with motivation
- Reduced concentration span
- Reduced information processing ability
- Impaired reasoning – ability to think logically, understand rules, follow discussions
- Impaired insight and empathy
- Reduced problem-solving ability
These cognitive effects can collectively be referred to as ‘executive dysfunction.’ These symptoms can make it increasingly difficult for a person with a brain injury to involve themselves in social interactions with their family, friends and co-workers as well as extending to issues in their ability to undergo day-to-day tasks and their usual job role duties.
Emotional and Behavioural – Affecting how the person feels and acts
- Personality changes
- Mood swings
- Sense of loss
- Frustration and anger
- Abusive or obscene language
- Obsessive behaviour
- Loss of confidence
Many of these effects may occur in any combination and there may be other less common effects that are experienced after brain injury. The effects are such that they affect individuals as well as their families after brain injury, with the severity of the symptoms depending on the severity of their injury and the area of the brain which is affected.
Is there a time limit for Brain Injury Compensation?
- Court proceedings must be started within three years from the date of the incident
- The time limit does not apply if the injured person is under 18 years old at the time of injury (when the time limit is extended until that person’s 21st birthday)
- The time limit does not apply to someone unable to manage their own affairs under the Mental Capacity Act 2005 criteria
- A victim of criminal assault has the right to see compensation from the Criminal Injuries Compensation Authority (CICA) which imposes a two year time limit to make an application (although the CICA can apply their discretion to permit cases outside this time period)
Brain Injury Rehabilitation
Rehabilitation is a process of assessment, treatment and management by which an individual, and their family and carers, are supported to achieve their maximum potential for physical, cognitive, social and psychological function in their participation in society and quality of living.
During recovery, other parts of the brain can take over activities of the damaged areas and new nerve pathways can be established. Through engaging in activity, alternative pathways can develop to allow the brain to reorganise itself to an extent, to regain lost function.
Insurance companies may provide financial help to assist with your rehabilitation in the form of interim payments.
It may not be possible to secure interim payments where it is difficult to establish liability. In such circumstances, your solicitor should seek to ensure that wherever possible you receive help from statutory bodies.
- A Case Manager may be employed who will organise the support and care you need
- Further Support Workers may visit you as often as necessary to provide essential support and assistance
Care and Adaptations following Brain Injury:
- It may be preferable to have a staged discharge from hospital which could involve returning home once or twice a week or an overnight stay to establish whether any adaptations will be needed for the home
- An Occupational Therapist from the hospital / rehabilitation team / social services should visit the home initially to assess your needs and any home adaptations (such as wheelchair ramps, handrails) that may be required
Community Care Services:
Your relative caring for you may be entitled to community care services such as:
- Help with bathing / washing
- Help with getting up / going to bed
- Help with shopping
- Help with cleaning, cooking, tidying
- Adaptations to the home
- Help with transport
The Local Authority can charge for services if people have assets above financial thresholds.
Occupational Therapist – recommended adaptations may include:
- Widening doors and installing ramps
- Providing or improving access to rooms and facilities (stairlift, downstairs bathroom)
- Adapting heating / lighting controls for easier use
Impact on the Family
Acquired brain injury can be a very sudden effect whereby families have to adjust to large changes in circumstances over a short space of time.
The two qualities which allow coping with these changes and assist in the vital rehabilitation process are the:
- Ability to be flexible
- Ability to communicate openly and honestly, directly expressing emotions
The recovery process involves progression through several phases with the support of caregivers. Whilst it can be long and demanding for both the injured and the family, there can be positive changes and the strengthening of relationships. The support networks available to assist families can provide care in areas which you may not have considered.
Each person’s coping strategy is different and the following recommendations may apply to your situation:
- Establish and maintain a daily routine
- Allow the person to rest frequently
- Be natural with the person and help them maintain their former status in the family
- Try not to overwhelm the person
- Point out every gain the person has made since the onset of the injury – such as by keeping a diary of progress
- Avoid making the person feel guilty for mistakes and accidents, such as spilling something
- Restrict the number of visitors (one or two at a time)
- Take it in turns to speak and listen to each other
- Present only one thought or command at a time
- Use a calm, soft voice when speaking
- Avoid crowded places, such as shopping centres and stadiums
Safety Guidelines – in the home:
Creating an environment which is as safe as possible for the person who has confusion or impaired judgment and may be unable to remember where dangers lie is essential:
- Keep clutter out of the hallway and off the stairs
- Removeable breakables and dangerous objects (matches, knives)
- Keep medications in a locked cabinet / drawer
- Make adjustments to the persons bed – such as keeping the bed low, install side rails
- Make sure rooms are well lit at night to help prevent falls
Hatch Brenner Solicitors is proud to be a long term supporter of Headway Norfolk & Waveney – a brain injury charity who offer a variety of support needs in the local community – contactable on 01603 788 114 or firstname.lastname@example.org
Carers Line: 0808 8080 7777
Tel: 0300 772 9600
NHS Carers Direct
Helpline: 0300 123 1053
Care and Social Services
Tel: 0300 683 000
Association for Rehabilitation of Communication and Oral Skills (ARCOS)
Helpline: 01684 576 795
Please contact one of the team to discuss your specific requirements: