Harry Stump, Esq.

Author: Harry Stump

  • DOES WEARING A COVID-19 FACEMASK INCREASE THE RISK OF INJURY?

    COVID-19 facemasks, while limiting the spread of the virus, also limited the peripheral vision of the wearer.  On or about March 19, 2020, there was a nearly national COVID-19 lockdown. A facemask was widely required for appearing in public.

    There is recognition in the medical literature that COVID-19 related mouth-nose masks restrict the visual field, even in persons with normal vision.  While the governmental requirement to wear facemasks has relaxed, there remains the possibility of future waves of virus and future requirements of facemask use when in public.  Some persons continue to wear a mask in pubic for protection.  Many health care facilities continue to require the use of facemasks to enter their premises.  Therefore, it is important to understand the effect of facemasks on vision and prevent or reduce the hazards created by them.

    Do facemasks affect healthy vision?  Is there a defined standard of facemask?  Do facemasks vary by size and shape?  Do different types of facemasks affect the visual field?  Does the position of the facemask on the face matter?  Is a nose clip on a facemask important?  What part of the visual field is affected by the wearing of a facemask?  Is the lower peripheral field of vision important for detecting and avoiding nearby hazards?  Does wearing a facemask obscure what otherwise might be considered an open and obvious hazard?  Should one wear a facemask while driving?  These are some of the issues raised and answered in the medical literature.

    In Navigating Through a COVID-19 World: Avoiding Obstacles. Klatt and Anson, J. Neurol Phys Ther. 2021, Jan: 45, this University of Pittsburgh-related article states that:

    The lower visual field is particularly important for obstacle avoidance and grocery shopping; individuals may don their mask before getting out of the car.      Thus, seeing the curb or potholes may be more challenging because of the mask while navigating across the parking lot into the store…. some masks block the lower visual field more than others…

    Their research found that some masks impair the lower visual field more than others but did not identify an “optimal” face covering.  They tested a bandana, a homemade facemask and a N95 face mask.  Their conclusion was the N95 mask wearer lost approximately an additional 3 feet of vision to observe obstacles the wearer approached.

    In Face masks, vision, and risk of falls, Kal, Young, Elmers, British Medical Journal, 2020; 371 :m4133 find that:

    “…face masks invariably block parts of the lower peripheral visual field…visual information from the lower peripheral field is important for detecting and avoiding nearby hazards, and for placing our steps safely.  Wearing a face mask reduces the wearer’s opportunity to use this important sensor information during walking and may therefore increase the chance of tripping or falling.”

    In Facemasks block lower visual field in Youth Ice Hockey; Critelli, Deminis, et. al., Frontiers in Sports and Active Living, December 2021.22, discuss:

    Wearing a facemask significantly restricts the lower field of view in youth hockey players significantly reducing the player’s ability to visualize the puck.

    In Mouth-nose masks impair the visual field of health eyes, Weber, Hohberger, et. al.  PLOS ONE, May 2021, found that visual field function was significantly impaired in the inferior-nasal sector when wearing a mouth-nose mask.  The article focused on the different types of masks used, the presence or absence of a nose clip and whether the nose clip was correctly used.  Home-made masks do not usually have a nose clip.  Failure to use a nose clip, or using one in the wrong way, were found to adversely affect the visual field.  The face mask is identified as an additional visual field artifact in the lower peripheral field.  Other visual artifacts include ocular diseases such as glaucoma.

    Many ocular and neurological diseases impair visual field.  Their visual field will be even more restricted, if these patients do wear a mask in the wrong way or wear a mask that cannot be worn closely to the nose.  An enhanced visual field loss can result in a higher risk of falling.  Incidents like falling might increase morbidity and mortality especially in elderly person…A study with young and healthy participants showed an increasing number of pedestrian collisions after constricting the participant’s visual field.  Using compensatory mechanisms (e.g. eye movements) reduced these pedestrian collisions, yet the number of collisions was still significantly increased compared to without restriction of visual field.

    The article warns against the increased risk of falling and also advises against wearing a face mask while driving:

    Therefore, wearing a mask while driving a car might be a reason for preventable accidents, even if the driver is young and healthy and uses compensatory mechanisms.

    Brick and mortar stores, among others, remained open during the face-mask requirement period as essential businesses, but, pursuant to the mask mandate, permitted access to only those persons wearing a mouth–nose mask cover.

    The medical literature indicates that wearing the COVID-19 facemask restricts the peripheral vision of the customer and causes increased falls and injuries to shoppers and other pedestrians.

    Because approximately 60% of in-store purchases are thought to be unplanned, current brick and mortar store interiors are designed to attract the attention of shoppers in order to generate sales.  Overstocked products, various displays, end caps and other attractions are designed to capture the customer’s attention.  Shoppers in a crowded store do not travel in lanes, but seem to zigzag through the aisles requiring one’s attention to avoid collisions.  A shopper’s vision is understandably divided.  Walking with one’s lower peripheral vision blocked by the COVID-19 face mask in this environment can obscure a waiting hazard.

    Would wearing a face mask be an effective answer to the open and obvious defense used against injured victims?   In the modern brick and mortar store, the owners or management of the premises should expect that a customer will not discover or realize the danger of hazards on the walkway, or will fail to protect themselves against it. This is especially true when the victim is wearing a facemask.

    “Tripping Hazards Absent” is an entry found on every Store Safety Checklist.  The National Safety Council Data Sheet I_495-Reaf 86 states that:

    1. Tripping hazards constitute one kind of unsafe condition that causes falls. Examples are merchandise left in aisles, extension cords lying across paths of travel, display, platforms, or merchandise racks protruding into traffic lanes…

    It is submitted that the prevalence of facemask wearing requires a higher degree of vigilance to eliminate tripping hazards by management of brick and mortar establishments open to the public.

    In conclusion, the current medical literature indicates that wearing the COVID-19 facemask can lead to more falling and tripping accidents while on foot and more motor vehicle accidents when the driver is wearing a facemask.  This is due to the unexpected loss of the lower peripheral vision of the wearer.

    As the wearing of facemasks may become a more common occurrence, especially for the more vulnerable parts of the population, as with any of the medical literature, FRIN (further research is needed) regarding this particular visual artifact.

     

     

     

  • AUTO ACCIDENT BROCHURE–WHAT TO DO AT THE SCENE

    STOP your car at or near the accident scene.

    CALL the police if anyone is hurt or dies.  Also, call the police if any vehicle is so badly damaged that it must be towed.

    GET the following information from the other driver or drivers involved in the accident:

    a)    Names and addresses

    b)    Telephone numbers

    c)     Driver’s license numbers

    d)     Registration numbers

    e)     Their insurance company names and policy numbers

    GET the names and addresses of:

    a)    People involved in the accident

    b)    Witnesses of the accident

    c)     Insured people

    RENDER AID: Pennsylvania law requires the driver of any vehicle involved in an accident resulting in injury or death to stop and remain at the scene until fulfilling his or her duty to give information and to render reasonable assistance to the injured.  You must give your name, address, registration number of your vehicle, and upon request exhibit your driver’s license and proof of insurance.  You must also render reasonable assistance including the making of arrangements for the conveying of the injured person(s) to a physician, surgeon or hospital if it is apparent that treatment is necessary or requested.  Failure to do this is a serious criminal offense, regardless of fault.

    If the police do not investigate an accident and someone has died or been injured, or if a vehicle must be towed, you may send a written report of the accident within five (5) days to : PA Department of Transportation Bureau of Highway Safety & Traffic Engineering Post Office Box 2047 Room 212, Transportation & Safety Building Harrisburg, PA  17105-2047.

    If possible, do not move the vehicles until a record of the accident has been made. Protect the scene, and help reroute traffic around the accident. Try to warn approaching motorists with flares, hazard lights, raising the hood of your car, etc.

    Call the police to have them come out to the accident scene to take a report.  They are much more likely to file a report about the accident if there were: 1) any laws broken, 2) any drugs or alcohol involved, 3) injury to any of the occupants requiring ambulance transportation or 4) towing of one of the vehicles is required.  If the police will not come out to the scene of the accident to file a report, you should go to the police station to file a counter report as soon as possible.  This is especially important to help you preserve your rights if you are the victim of a hit and run incident and may be making an uninsured motorist claim against the insurance company.

    Try to make sure that all drivers, passengers, pedestrians and witnesses remain at the scene of the accident.  If they insist on leaving, write down their names, addresses, phone numbers, license plate numbers, etc., and an account of what they saw.

    Take down the name of the police officer and his badge number. Ask him when and where you may pick up a copy of the accident report.

    Both drivers must identify themselves to each other.  Copy down information contained on the other driver’s license, vehicle registration and insurance card.  Likewise, identify all passengers and witnesses.  You will need their names, addresses and phone numbers.

    Make a diagram of the accident, showing the positions of the cars before, during and after impact; position and length of  skid marks, note the positions of traffic lights and street signs, estimate the respective driving speeds, and record details about traffic and the weather and road conditions. If possible, have photographs taken of the accident scene and of any damage or injury.  Photograph everything including your car, other car or cars involved, and the accident scene.  Remember to use your cell phone camera.  If you do not have a camera at the time of the incident, try to bring a camera back to the scene as soon as possible.

    Write down what everyone said after the accident, especially what was said by the other driver or drivers.

    VERY IMPORTANT: Do not admit to any fault for the accident. Do not volunteer information or comment on the accident. Do not sign any pieces of paper nor agree to pay for damages. You should, however, cooperate with police officers investigating the case. You must sign traffic tickets – but this in itself is not an admission of guilt or wrongdoing. You must take an alcohol test if requested, or risk losing your license for one year. Advise the officer of basic facts, without adding personal comments or interpretations. Keep calm.

    VERY IMPORTANT: If you are the victim of a hit and run driver or an unidentified driver who forces you to take evasive action and injure yourself or others, you must report this incident to the police department and to your own insurance company within thirty (30) days or you will lose your rights.  Check your insurance policy immediately.  One major insurer requires that you must give the insurance company a sworn statement within 30 days.  This sworn statement must state that the insured has a legal action due to the accident.  It must also include facts to support the action.

    As soon after the accident as possible, it would be a good idea to be checked out by the emergency room or a doctor. Never refuse a suggestion from a paramedic that you allow an ambulance to take you to a trauma center.  Even if there are no initial signs of pain, there might have been damage done to the neck or spinal cord. There are very fine multi-disciplinary clinics that specialize in the treatment of traumatic injuries – those which are specific to automobile accidents.

    VERY IMPORTANT:  You should talk to a personal injury lawyer at this time to clarify your rights and discuss questions of liability for the accident. 

    Do not discuss this accident on any social media. 

    You will need to contact your insurance company to report the accident and get an application for benefits. Pennsylvania law provides for no-fault medical insurance in automobile accidents up to the limits of your first party benefits.  If that benefit is exhausted the law provides that your personal health insurance is next to pay.

    This Blog is not intended to take the place of legal advice for any specific legal issue.  It is intended to be educational and illustrative.  As always, it is best to consult a lawyer who regularly practices in this area for legal advice.

     

     

  • DISTRACTED DRIVING

    Driver error is estimated to cause approximately 95% of all car accidents. Alcohol is involved in approximately 1/3 of all accidents. The National Safety Council (NSC) estimates that more than 1/4 of all auto accidents are caused by distracted driving. This estimate may be very low because of the driver reluctance to admit distraction, lack of witnesses inside the vehicle, lack of cell phone usage records by police and the large number of distractions available to a driver inside their motor vehicle.

    In five seconds of texting at 55 miles per hour, a car travels the length of a football field. Even at 30 miles per hour, the car can travel 60 yards. Two to four thousand pounds of steel, plastic and glass can cause a lot of damage to an unfortunate pedestrian or bicycle rider struck by the vehicle. There are approximately 10 million car accidents each year in the United States causing over 37,000 deaths. As many as 9,000 pedestrians and cyclists are among the dead.

    Driver distractions have been organized as Visual, Auditory, Manual and Cognitive Distractions.

    Visual distractions include what has been described as “rubber necking” such as looking at police activity on the roadside, a person outside of the vehicle, roadside animals, bill boards, a dropped object inside the vehicle, a passenger in the vehicle, the family dog, an insect, changing the radio, looking for the cell phone or other papers.

    Auditory distractions include talking of a cellphone (hand- held or hands-free), speaking or arguing with passengers

    Manual distractions include texting, reaching for or dialing a cell phone, manipulating the dashboard screens, changing the radio stations, inserting a CD, controlling windows or mirrors, locking the doors, adjusting mirrors, seat belts, reaching for items inside the vehicle. This also includes reaching and consuming food or beverages.

    Cognitive distractions include attempting to read or compose text messages, day dreaming, talking to or arguing with passengers, fatigue, being stressed, under the influence of drugs or alcohol, or focused on a work or personal problem.

    This list is illustrative of the problem. Law enforcement may identify some of the alcohol or drug causes. It is possible to secure cell phone records. But there is no current practical method to identify the more than thirty other causes of distracted driving.

    At some time in the future, the autonomous motor vehicle may allow all of the occupants to eat, drink, sleep, read, talk on their cell phones and play with the family dog without causing the estimated 95% of driver error caused accidents. However, the path to the fully autonomous vehicle may be further in the future than we think. It will take decades before all of the human-operated motor vehicles are off of the road. The autonomous vehicle will surely present a new set of hazards. In the interim, it will be important to focus on the life-saving car technologies that are currently available and ensure that they are required in pre-autonomous motor vehicles.

  • THE PHANTOM, UNIDENTIFIED OR HIT AND RUN DRIVER

    One client was riding her motorcycle on a Nevada road when she ran over an object that had been previously dropped from an unsecured load from an unidentified vehicle. She was seriously injured and life-flighted to a trauma center hospital.

    Another client was injured when forced off of the roadway and into a tree by a vehicle driving on the wrong side of the road. The negligent driver never stopped and could not be identified.

    A third client was injured by a person who failed to pay their automobile insurance premium and was driving without any automobile insurance.

    It was fortunate that each of the three client’s automobile insurance policy included uninsured motorist coverage. When injured by a phantom, unidentified or hit and run driver, it is very important to comply with the following rules.

    If you are the victim of a hit and run driver or an unidentified driver who forces you to take evasive action and injure yourself or others, you must report this incident to the police department and to your own insurance company within thirty (30) days or you will lose your rights.  Check your insurance policy immediately.  One major insurer requires that you must give the insurance company a sworn statement within 30 days.  This sworn statement must state that the insured has a legal action due to the accident.  It must also include facts to support the action.  Source: 75 Pa.C.S.A. § 1702. Definition of uninsured motor vehicle (3).

    It is also important to buy as much uninsured and underinsured motorist coverage as you can afford. Often an insurance agent will give you a form to reduce this coverage to “save you money.”  Never reduce this coverage.  Purchase stacking to double or triple your coverage.  This insurance coverage protects you and your family.  The phantom, unidentified or hit and run driver did not care about you or your family.

  • SURVEILLANCE CAMERAS

     

    “Smile, you’re on Candid Camera” was the gotcha phrase on the long running popular “Candid Camera” television show. This show involved the use of concealed cameras filming ordinary people doing strange things. Today, most cell phones have video cameras that are readily available to the public.  This makes it easy to film the injured person and extremely cost effective.

    Injured persons with accident claims of inability to work, lift, carry or pursue hobbies should be aware of the possibility that insurers will hire investigators to film them without their knowledge. If the film indicates that the injured person has lied or exaggerated their disability, this will be used to diminish or even defeat the claim for damages.  A common jury charge by the court states that if the jury finds that the witness has been false in one thing, then the jury could conclude that the witness has been false in all things.

    The surveillance video is different from the security camera accident scene video found inside most retail stores and many outside areas. This security video may capture the actual accident itself as well as conditions that existed for a period of time before the accident.  The video evidence may help the plaintiff establish that the defendant had actual notice of the dangerous condition that caused the accident and establish liability.

    Insurers will not usually produce a security accident scene video to the plaintiff before a lawsuit is filed. They often refuse to produce these videos until after the plaintiff’s deposition because they want to use it to impeach the plaintiff during the deposition.  Impeachment can consist of outright falsehoods or inconsistencies in testimony so as to cast doubt on the testimony.  A motion to compel production should be successful in forcing the defendant to produce the video before the deposition.  A sample motion that was successful in federal court appears elsewhere on this blog.

    The surveillance video can be made at any time after the defendant has notice that a claim is made. Defendants are usually successful in withholding production of the surveillance video until after the deposition because it is generally used solely for impeachment. If the surveillance video supports the plaintiff’s claim, it may not become known or used.  It can be devastating for the plaintiff’s case to question the plaintiff who claims the inability to work when faced with a video of him or her chopping wood preserved on film.

    The injured plaintiff should be always aware of the possibility of an investigator for the defendant making a video of them doing something inconsistent with their claimed injuries.

  • MILD TRAUMATIC BRAIN INJURY & VESTIBULAR REHABILITATION THERAPY

    Vertigo may occur after an accident involving Mild TBI.  Vertigo is a sensation that makes you feel like the world is moving around and that you might lose your balance.

    The vestibulocochlear nerve is the eighth cranial nerve.  It is composed of vestibular fibers and cochlear fibers.  The vestibular portion senses changes in the position of the head while managing body balance and eye movement.  When this nerve is damaged, it often is unable to heal.

    Vestibular Rehabilitation Therapy is offered at concussion treatment centers to treat symptoms of vertigo, dizziness, vision difficulties and imbalance.  This is a specialized exercise program designed to teach the brain to compensate for the damaged vestibular organs by using other senses to substitute for the damaged vestibular system.  Depending on the patient’s specific findings, treatment may include Habituation exercises, Gaze Stabilization and/or Balance Therapy

     

    Habituation Therapy is for patients with dizziness caused by the movement of the head or by being in a visually stimulating environment.  This therapy consists of repeated controlled exposure to those movements and visual stimuli.

     

    Gaze Stabilization Therapy is designed to improve control of eye movements and result in clear vision when the patient moves their head. This therapy consists of focusing on an object while the head is moved side to side and up and down for periods of time.

     

    Balance Training Therapy is designed to help the patient walk without falling doing the daily routines of life, such as stepping over a curb, climbing steps or getting out of bed.  In this therapy, the patient will perform exercises with their eyes closed or ambulate on different surfaces to improve balance.

     

    Injured persons with any of these problems should seek specialized medical care to arrive at a diagnosis and prescribe the appropriate care and treatment.  This specialized medical evaluation may improve your healthcare outcome and provide valuable medical evidence of injury in the event of an accident settlement.

     

  • MILD TRAUMATIC BRAIN INJURY & NEUROPSYCHOLOGICAL TESTING

    An accident victim leaves the emergency room with negative findings on x-rays, CT scans and MRI scans of the brain.  The victim continues to suffer from headache, confusion, lack of coordination, memory loss, nausea, vomiting, dizziness, ringing in the ears, sleepiness, and/or excessive fatigue.

    This person has many subjective symptoms but has no objective evidence of any cognitive defect.  A subjective symptom is a symptom that a person says they have.  An objective symptom is a symptom that can be measured or verified.

    An example of the value of objective evidence of mild TBI can be found in the Veterans Administration claims process.   If this were a Veterans Administration claim, the lack of any objective evidence in a TBI claim might lead to a 0% or 10% disability rating.  Objective evidence of cognitive defect from a neuropsychological test might lead to a 40-70% disability rating.

    A neuropsychological test is administered by an experience PhD psychologist from an accredited Neuropsychological program.   Neuropsychological tests objectively and scientifically measure how your impairment is impacting your attention span, memory, learning perception, problem solving, recall, speed processing, verbal functioning, and executive functioning, among other things.

    The test consists of an interview, a detailed review of the medical history, observations, self-report questionnaires and tailored standardized tests.  A report will be prepared and outline what, if any, cognitive defects the patient has, the severity, extent and the cause thereof.

    If you were in a car accident and had any or all of the above concussion symptoms, an insurance company would be more willing to offer a better settlement of your claims based upon the result of a neuropsychological test than your  subjective symptoms and negative emergency room testing.

  • MILD TRAUMATIC BRAIN INJURY/CONCUSSION

    A 2015 article in the Journal of Psychology and Clinical Psychiatry states that Mild TBI may represent 70-90% of all brain injury cases that require medical attention.  After an accident, the injured party visits a hospital emergency room where x-rays, CT-scans and/or MRIs are reported as negative.  The literature states that the symptoms usually resolve within 3 months, but that 20-30% of injured persons have symptoms up to 6 months and 10-15% have chronic symptoms.

    These concussion symptoms may include difficulties: with balance and stabilizing vision; with coordinating eye movements; ability to concentrate or remember; migraine headaches or anxiety.

    Some of the treatments available include neuropsychological testing; vestibular or ocular motor screening and other therapies.

    Because the original emergency room x-rays and scans were reported as negative, there is not any objective medical evidence of injury.  The medical field is increasingly specialized and concussion therapy is available at hospitals that have these specialized clinics.

    From a medical perspective, it is important to diagnose what is causing these symptoms and get the proper treatment.  From a legal perspective for persons injured in an accident, it is important to have objective evidence of an injury caused by the particular accident and a measurement of disability.

  • PERSONAL DOCUMENTS

     The following are some of the personal documents that you should consider having in the event of the unexpected happening:

     

    WHY YOU NEED A WILL

    If you do not have a will and something unexpected happens, your home, money, and other property will be distributed according to a formula fixed by the law of the State in which you are domiciled.  Your estate will be managed by someone who might not be the person you trusted to handle your affairs.  Your minor children may be placed in the custody of someone you would not have chosen if asked.

    This law is the same for everyone and does not take your special situation or wishes into consideration.

    A will is a legal document.  Always seek legal help in preparing or changing your will.  In it you name a personal representative to administer your estate.  You also specify how your estate will be divided.  You also name a guardian of the person and the estate of your minor children.

    A will can be changed at any time during your lifetime.  It should be reviewed in the following circumstances: marriage or divorce; if you have a child; when you want to change your beneficiaries; or when you want to change your personal representative.

     

    LIVING WILL

    A Living Will details whether or not you want to prolong your life by the use of extraordinary medical treatment.  In the event that you would be unable to communicate what you want, a Living Will spells out, in advance, what medical treatments you would or would not want to have performed.

    For example, suppose you had a stroke and were only to be kept alive by use of a respirator with no hope of getting better.  If the respirator was removed you would pass away.  Without a Living Will the decision to remove a respirator would be left to your family, your doctor, and possibly the courts.  Don’t you want to make the decisions about whether or not to prolong your life and under what circumstances those decisions are to be made?  Your written decision may avoid unpleasant family disagreements.

     

    HEALTH CARE POWER OF ATTORNEY

    This document gives your agent, who is the person you trust, the authority to make all of your healthcare decisions.  If an event should ever occur that would render you unable to make decisions for yourself, a Health Care Power of Attorney document would assure that your trusted individual could make decisions for you.  Although your next of kin may be able to make most health care decisions’ for you if you could not make them yourself, a health-care power of attorney may prevent family disagreements.

     

    DURABLE GENERAL POWER OF ATTORNEY

    A Durable General Power of Attorney authorizes your agent to make financial decisions on your behalf.  The Durable General Power of Attorney remains in effect should you become mentally incapacitated.  The extent of the power can be as broad or as limited as you specify from paying your bills to making investments, entering into contracts, selling your home, or other legal decisions

     

    PICKING A GUARDIAN FOR YOUR MINOR CHILDREN

    A recent interesting article stated that one of the reasons that many people do not have a will is that they cannot decide who they want to be the guardian of their children in case they are no longer here.  If only one of the parents would die, then the surviving parent almost always would get custody.  But if both parents were to die, then someone has to take charge of the children.  If you do not pick a guarding, then you have left it up to the courts.  Some of the factors that should go into the decision making process are:

    • HEALTH—Naming someone of your own generation may be preferable to naming your parents, if the children are infants and the parents much older.
    • MONEY—This can be a big consideration if you are unable to leave enough assets to provide for the children.
    • TIME—If your first choice has four children of their own, will they have the time to care for yours?
    • GEOGRAPHY-–Do you want your children to have to relocate?
    • VALUES-–If, for example, you want your children raised in a certain manner, does your first choice share your values?

    Should you name one person as a guardian or include their spouse.  What if they divorce?  List all of the people you are considering, then work through the above list.  Hopefully, a clear choice will emerge.  Pick an alternate if you first choice is unable to serve when needed.

     

  • BRAIN INJURY SEVERITY

    Not all brain injuries are the same.  They can range from total and complete disability to a spectrum of unpleasant changes.  The severity of a brain injury can be assessed by either the Rancho Los Amigos or Glasgow Coma Scale.

    The Rancho Los Amigos scale ranges from Level 1 (No response to ALL stimuli) to Level 10 (Purposeful Appropriate-responds to all stimulus).  The Glasgow Coma Scale ranges from one (does not open eyes, makes no sounds, makes no movement) to fifteen (opens eyes spontaneously, oriented and converses normally, and obeys commands.  The Glasgow Coma Scale focuses on eye, verbal and motor.

    It would be expected that persons with low scores on either scale need and are receiving expert medical care because of the severity of their condition.

    On the Mild TBI spectrum of brain injuries, there may be headache, confusion, lightheadedness, dizziness, blurred vision or tired eyes, ringing in ears, loss of energy, sleep problems, changes in behavior and disposition, problems with memory, concentration, vision or sensitivity to light.

    With Mild TBI after an accident, a person might be released from an Emergency Room with a form that suggests the patient follow-up with their medical provider.  Some persons may not follow this advice.

    There are concussion clinics available that screen for Vestibular and Ocular Motor function and provide neuropsychological testing.  These clinics provide specialized treatment for these diagnosed problems.

    If you are injured in an accident and have experienced any of the above changes, you owe it to yourself to be thoroughly evaluated at a concussion clinic.  The medical benefit is that you will heal.  The legal benefit is that you will have an objective evaluation of your Traumatic Brain Injury.