CONCUSSION, MILD TRAUMATIC BRAIN INJURIES-LONG OVERLOOKED.
For decades, our society has neglected the consequences of Traumatic Brain Injury (TBI). Only recently, have we awakened Chronic Traumatic Encephalopathy (CTE) in professional football players.
Notwithstanding a lot of improvement, our society remains much in the dark ages in every other aspect of traumatic brain injuries outside of professional football-notwithstanding a growing amount of research that continues to add meaningful research into the severity of the consequences that result from even mild Traumatic Brain Injury.
Car accident cause many concussions and traumatic brain injuries.
60% of the victims of TBI in motor vehicle collisions are being grossly overlooked. They are being overlooked by medical and chiropractic professionals. They are being overlooked by personal injury lawyers that do not understand concussion injires and are not skilled and experienced in recognizing and dealing with concussion injuries.
America has recently awakened to the fact that concussion injuries are huge problem. Mild Traumatic Brain Injuries can lead to significant lifelong impairment affecting a person’s ability to function physically, cognitively and psychologically. This problem needs to be recognized in regard to the consequences of car accidents and motor vehicle collisions.
Mild Traumatic Brain Injuries Often Result in Major Disability.
It is well recognized by those “in the know” about concussions and Traumatic Brain Injuries that often major disabilities result from “mild” Traumatic Brain Injuries (MTBIs). Further, the disabilities can be life-long and serious consequences.
These life-long disabilities are now being recognized and researched by the Department of Defense regarding armed forces personnel returning from combat who received TBIs that were not recognized at the time. They are being recognized by the National Football League and the NCAA in football players. Much research remains to be done regarding the victims of TBI from car accidents and workplace injuries.
The Schmidt Salita Law Team Has Special Skill and Experience with Concussion Injuries.
The Schmidt Salita Law Team, formerly Schmidt Law Firm, is one of the leading personal injury firms in the entire United States in bringing justice to the victims of concussion injuries and mild traumatic brain injuries.
Doug Schmidt has been a pioneer in the recognition of the consequences of concussions and mild Traumatic Brain Injuries. He served as President of District 6 Youth Hockey which included the youth hockey programs for Eden Prairie, Edina, Minnetonka, Bloomington Kennedy, Bloomington Jefferson, Richfield, Burnsville, Apple Valley, and Eastview. In that capacity, Schmidt worked with Dr. Mark Stuart of the Mayo Clinic to develop one of the earliest programs of concussion awareness and sidelined detection of concussions.
Team member lawyer Dean Salita is also very experienced in successfully handling concussion and Traumatic Brain Injuries resulting from workplace injuries in the Minnesota Workers Compensation arena. For many years, Mr. Salita has worked with his clients and their doctors not only to help them with their legal cases but also to assure that they receive the proper care and treatment to assure a maximal quality of life in the face of their brain-injury related disability.
Concussions Are Often Overlooked by Emergency Medicine Doctors.
Recently, an article that appeared in the Journal of the Academy of emergency medicine containing addition that emergency department doctors cannot reliably diagnose concussion and traumatic brain injuries. That is true for a number of reasons. Many concussion injuries are simply overshadowed by the symptoms of shock and pain from other physical injuries that detract from the examiner’s attention from a possible concussion injury. Often, the victims of car collisions are treated with pain medication that interferes with the possible detection of a concussion injury. Finally, it is well recognized in the medical literature that the symptoms of a concussion injury often develop progressively over days, weeks, and months following the trauma exposure. All of these factors collectively interfere with the initial diagnosis of the concussion injury.
Doctors of Chiropractic Should Be the Safety Net for Concussion Detection.
All of these factors add up to the simple conclusion that Doctors of Chiropractic occupy a special place in the health care system that allows them to be the “safety net” that prevents a significant concussion injury from being totally overlooked. Doctors of Chiropractic typically have the opportunity to see and treat the patient days and weeks following the exposure to the trauma, when the symptoms have progressed and developed to the point where effective diagnosis can occur.
History of Post Traumatic Amnesia Is An Important Factor.
Respected medical authorities have established that post traumatic amnesia (PTA) is the single most important factor in predicting the nature and extent of disability resulting from a concussion or mild traumatic brain injury. PTA is now considered to be a far more important factor in predicting the severity of the resulting disability than Loss of Consciousness (LOC). In fact, the World Health Organization has promulgated an ICD10 Code for “Concussion without Loss of Consciousness”.
Accordingly, it is extremely important to document the details regarding the posttraumatic amnesia.
Post traumatic amnesia is defined as the state of confusion that occurs immediately following a traumatic brain injury in which the injured person is unable to remember recall the events occurring after the injury. It is very common for the victim to be able to communicate with first responders and medical providers but have no ability later to recall those events.
Post traumatic amnesia is also well known to involve sketchy and intermittent, often interrupted, periods where the events are not recalled. For that reason, a careful history is required to establish what things the victim recalls and does not recall. The end date of the period of post traumatic amnesia is generally considered to be the time at which the recall has become mainly continuous.
Documentation With the Proper Medical Diagnostic Coding Is Important.
It is important that the Doctor of Chiropractic diagnose the concussion injury. It is equally important that the diagnosis be properly documented with the proper ICD10 Coding. The following ICD10 Codes are typically appropriate for the symptoms of Concussion and Post Concussion Syndrome:
BASIC CODING FOR CONCUSSION/MILD TRAUMATIC BRAIN INJURY
S06.0x0 Concussion without loss of consciousness
S06.0x0 Concussion with loss of consciousness of 30 minutes or less
S06.0x0 Concussion with loss of consciousness of 31 to 59 minutes
S06.0x9 Concussion with loss of consciousness of unspecified duration
R 41.1 Anterograde amnesia
R 41.2 Post traumatic (retrograde) amnesia
R 41.0 Post traumatic confusion/disorientation
CODING FOR TYPICAL SYMPTOMS OF POST CONCUSSION SYNDROME
R 41.840 Posttraumatic attention and concentration deficit
G 44.3. Post-traumatic headache
R42 Post-traumatic dizziness/giddiness/vertigo
R11 Post-traumatic nausea and vomiting are 11
H93.11 Post traumatic tinnitus-right ear
H93.12 Post traumatic tinnitus-left ear
G 47 Post traumatic sleep disorder
41.840 Post traumatic cognitive dysfunction-attention/concentration deficit
R 41.842. Visuo-spatial deficit/blurred vision/double vision/convergence deficit
Treatment of the Post Concussion Syndrome Should also Involve a Skilled Medical Doctor.
The role of the Doctor of Chiropractic in the initial diagnosis of a postconcussion syndrome is very important and continued treatment by the chiropractor of the neck and back injury and associated headaches is very appropriate. However, the primary care of the concussion injury itself will typically need the involvement of medical doctors specially trained in the care and treatment of mild traumatic brain injuries.
Some mild traumatic brain injuries involve visual problems. Blurred and double vision is a common symptom. More serious cases may involve a saccadic deficit for the ability of the eyes to scan is limited. They may also involve a convergence insufficiency, where in the ability of the eyes to focus from near to far range and vice versa is compromised. Victims with those visual impairments should seek the services of a neuro-ophthalmologist who specializes in visual impairment secondary to traumatic brain injuries.
Some mild dramatic brain injuries also involve dizziness and balance problems, some of which are diagnosed as vertigo (spinning sensation) or even Benign Paroxysmal Positional Vertigo (BPPV) which falls within the specialty of Neurotology.
The Involvement of a Personal Injury Lawyer Specializing in Concussion Injuries Is Also Important.
Many concussion injuries are overlooked by the medical community. Many more are never detected because the victims doesn’t understand that he or she has suffered a concussion injury-and never seek treatment. Often, it is a family member that notices the change.
Many more are overlooked by the typical personal injury lawyer. The personal injury lawyers on the Schmidt Salita Law Team consider it an important duty of the personal injury lawyer to recognize when their clients have sustained a concussion injury that would otherwise be overlooked and bring justice to the case.
The Schmidt Salita Law Team offers free consultations regarding personal injury or wrongful death cases. They will analyze your case and provide a free initial assessment of what would be involved in bringing a claim in your case. They will help you to understand the risks and benefits of bringing such a claim. They will explain to you the benefits of a contingent fee agreement.