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Straight Track #131

 

Traumatic Brain Injury:
Not A Simple Diagnosis

Craig C. Church
Hoey & Farina Attorney
1-888-425-1212

A traumatic brain injury (“TBI”) can have serious long-term effects that interfere with a railroader’s job and daily life. TBI can result when one’s head is struck with force. 

However, a railroader does not need to hit his head on an object to injure his brain. Sudden and violent head movement may also produce brain injury. 

TBI is significant because it affects a railroader’s ability to function. Loss of function depends upon the area of the brain that is damaged. A railroader with TBI may look the same, but the railroader is not the same person. [See Traumatic Brain Injury Checklist ]

Symptoms of brain injury can include headaches, memory problems, word finding difficulties, fatigue, changes in emotion, sleep changes, dizziness, changes in vision, smell or taste, feelings of being overwhelmed by noise or crowds, impulsiveness, poor concentration, distraction and lack of organization. Generally, four or more of these symptoms suggests that the railroader should be evaluated for TBI by medical professionals. 

Diagnosing TBI can be difficult. MRI or CT scans can show bleeding in the brain. Bleeding creates pressure that can damage brain tissue; however, the MRI or CT scan can be “negative”, or in other words “normal”. This does not mean that a railroader does not suffer from TBI. The railroader may have a serious brain injury, yet the CT scan or MRI may be negative. It may be necessary to obtain testing by a neuropsychologist to detect TBI. These tests are 90-95% accurate in diagnosing TBI. Other tests, such as an EEG, which measures brain electrical activity, or a brain spectrograph, which measures blood flow, may be required to adequately evaluate the injury. 

The key for the railroader with TBI is to establish a good working relationship with his doctors. A railroader should get his doctors to understand his situation by keeping a written list of problems he is encountering. It is especially important to keep a symptoms list when suffering from TBI because TBI can result in memory loss. It is also important to begin a head injury program. A head injury program is therapy designed to improve functioning skills and to develop coping approaches. Studies show that the earlier the head injury program is started the better the recovery.

It also may be necessary to involve a psychiatrist to help the injured railroader deal with emotional and behavioral problems resulting from the brain injury. Many of our clients have experienced depression after TBI. A psychiatrist can prescribe medication to help with this problem. Psychologists also can help the injured railroader deal with emotions, control behavior and assist the railroader’s family during the recovery process. In order to further improve, an injured railroader also may need to work with speech and language pathologists, occupational therapists, and vocational rehabilitation counselors. 

With appropriate treatment and time, many activities of daily living (“ADLs”) can be restored, and most railroaders will improve, although recovery from TBI is never 100%. The railroader with TBI is going to be left with some permanent impairment. Unfortunately, in some instances, a railroader may not be able to continue to perform his job because his ability to function is impaired. 

The Federal Employers’ Liability Act (“FELA”) provides for money damages for railway workers suffering from traumatic brain injury who were injured on the job. Under the FELA, a railway worker may recover money damages for past and future lost income, as well as any past and future pain, suffering and disability resulting from the TBI. 

If you have any questions or concerns, please do not hesitate to contact us, your designated legal counsel, at 1-888-425-1212.


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