Brain Injury Lawyer in Delaware County and Philadelphia: Proving a TBI the Scan Might Miss

Can you bring a claim for a brain injury in Pennsylvania?

Yes. If someone else's carelessness caused your brain injury, Pennsylvania law lets you seek payment for medical care, lost income and, in many cases, the change in your life, from that person or business and their insurer. The hard part is rarely the law; it is proving an injury that often does not show up on a standard scan.

Brain injury claims come from car and truck crashes, pedestrian and bicycle collisions, falls on unsafe property, and accidents on SEPTA vehicles and platforms. Each type of case has its own rules on insurance, deadlines and who can be sued, and those rules decide how the injury has to be proven.

Types of brain injury we see

A traumatic brain injury, or TBI, happens when a blow, jolt or sudden movement disrupts how the brain works. Doctors often grade a TBI as mild, moderate or severe based on things like loss of consciousness, memory loss around the event, and the Glasgow Coma Scale score recorded by paramedics or in the emergency room. A "mild" label describes the first hours, not how the injury affects you months later.

• Concussion: a mild TBI caused by the head striking something or by the brain moving inside the skull. Many people recover in weeks. Some do not.
• Post-concussion syndrome: symptoms that hang on well past the expected recovery window, such as headaches, dizziness, trouble concentrating, memory gaps, poor sleep, irritability and sensitivity to light or noise.
• Diffuse axonal injury: stretching and tearing of nerve fibers across the brain from rapid rotation or deceleration, common in high-speed crashes. It can cause serious impairment while early imaging looks nearly normal.
• Contusions and bleeding: bruising of brain tissue or bleeding between the brain and skull (subdural or epidural hematoma), which may need emergency surgery.
• Penetrating and skull fracture injuries: damage from an object entering the skull or from a fracture pressing on brain tissue.

How brain injuries happen in Delaware County and West Philadelphia

Car crashes cause many of the head injury cases we hear about, and the forces involved do not require a head strike. A rear-end impact at a light on West Chester Pike or Baltimore Pike can whip the head forward and back hard enough to injure the brain. Higher-speed crashes on I-476 or the Schuylkill Expressway add the rotational forces linked to diffuse axonal injury.

Falls are the other big category. A slip on an icy walkway, a broken stair in a rental building or a wet floor in a store can send someone backward onto concrete. Older adults are especially vulnerable to bleeding on the brain after a fall. Pedestrians and cyclists struck by a vehicle often suffer head trauma even when they were wearing a helmet.

SEPTA accidents raise their own issues. A passenger thrown by a sudden stop on a bus or trolley, a fall on a platform or stairway at the 69th Street Transportation Center, or a pedestrian struck by a SEPTA vehicle all involve a public transit authority, a short notice deadline and a damages cap. Our SEPTA accident page explains those rules.

Why brain injuries are hard to prove

The emergency room's job is to rule out a bleed or fracture that needs surgery tonight. A CT scan is good at that. It is not designed to show the microscopic damage behind many concussions and diffuse axonal injuries, so a normal CT does not mean a normal brain. Standard MRI can also miss this kind of injury. Newer imaging methods exist, but whether they are reliable enough for court is often disputed, so they rarely carry a case alone.

Insurers know this. A common defense argument is that the scans were clean, you went back to work, and your symptoms come from stress, age or an earlier condition. The answer is a claim built on several kinds of evidence that point the same way.

How we build proof of a brain injury

No single test proves a TBI. A strong claim usually combines records from the first day with evidence gathered over the following months.

• First-response records: the police crash report, EMS run sheet and emergency department notes showing confusion, vomiting, memory loss or a Glasgow Coma Scale score below normal.
• Neurological follow-up: a neurologist's diagnosis and treatment notes tracking headaches, dizziness, vision problems and cognitive complaints over time.
• Neuropsychological testing: hours of standardized testing of memory, attention, processing speed and executive function, with built-in checks for effort, that can show deficits a scan cannot.
• Before-and-after witnesses: coworkers, supervisors, friends and family who can describe how you functioned before the injury and how you function now.
• Work and school records: performance reviews, missed days, reduced hours, grades and accommodations.
• Life care planning: for serious injuries, a written plan from a qualified professional that lists future therapy, medication, supervision, equipment and home care, which an economist can translate into a present-day cost.

Limited tort and brain injuries

If your brain injury came from a car crash, your own auto policy matters. Under 75 Pa.C.S. § 1705, a person bound by the limited tort option can recover economic losses such as medical bills and lost wages, but cannot recover for pain and suffering unless the injury is a serious injury. Pennsylvania defines serious injury as death, serious impairment of body function, or permanent serious disfigurement (§ 1702).

A brain injury with lasting effects on memory, concentration, balance or the ability to work can meet the serious-injury standard. A concussion that fully clears in a few weeks may not. That is one more reason the medical documentation matters so much in a TBI case.

Limited tort may not apply at all. Section 1705(d) restores full tort rights in listed situations, including when the at-fault driver is convicted of DUI or accepts ARD for it in that crash, drives a car registered in another state, or carried no insurance, and when you were riding in a vehicle other than a private passenger vehicle, such as a bus or trolley. Your first-party medical benefits pay early bills regardless of fault; every Pennsylvania policy includes at least $5,000 of them (75 Pa.C.S. § 1711).

What a brain injury claim can include

Value depends on the severity of the injury, how long symptoms last, whether you can return to your job, your tort election, and the insurance available. No honest lawyer can give you a number at the start. The categories of loss usually include:

• Past and future medical care, including therapy, medication and cognitive rehabilitation.
• Lost wages and loss of future earning capacity if you cannot return to the same work.
• Pain, suffering and loss of life's pleasures, where your tort status allows it.
• Home care, supervision and household help your family now provides.
• Loss of consortium claims by a spouse whose marriage has been affected.

Help from Pennsylvania's Head Injury Program

The Pennsylvania Department of Health runs a Head Injury Program that pays for rehabilitation services for people with a traumatic brain injury who qualify. It has eligibility rules, including income guidelines and a requirement to use other available resources first, so it is not a substitute for a claim against the person who caused the injury. We can talk with you about how the program and your claim fit together.

Deadlines for a brain injury claim

Pennsylvania generally gives you two years from the injury to file a personal injury lawsuit (42 Pa.C.S. § 5524). For a child, the clock is generally paused until the child turns 18. If SEPTA or another government unit is involved, written notice is generally due within six months (42 Pa.C.S. § 5522), and caps apply to damages against SEPTA (42 Pa.C.S. § 8528).

Brain injury symptoms sometimes surface or worsen weeks after the event, which tempts people to wait. Do not. Video, vehicle data and witness memories fade quickly, and the early medical record is often the evidence that carries the case. If you were partly at fault, Pennsylvania's comparative negligence rule reduces your recovery by your share of fault and bars it if your share is greater than the combined fault of the defendants (42 Pa.C.S. § 7102).

Working with Warren I. Siegel

Warren has practiced in Pennsylvania since 1992. He has served the Philadelphia court system as a Discovery Master in medical malpractice matters and as a Settlement Master for the Court of Common Pleas, work that involves sorting through complex medical evidence. People with brain injuries often find phone calls and paperwork exhausting, so we keep communication simple and include a family member when you want one there.

Your Legal Warrior works on a 100% contingency fee. There is no attorney fee unless we recover. The firm advances all case costs, those costs are repaid only from a recovery, and if there is no recovery you owe nothing.

If you or someone in your family has a concussion or brain injury from a crash, fall or SEPTA accident, call (267) 412-4601, answered 24 hours a day, 7 days a week, or send the free case review form from our office at 8000 West Chester Pike in Upper Darby.