Brain Injury Checklist
Hidden brain injuries are one of the most difficult medical cases to put together. The medical findings are subtle, the clues nebulous, but the results are dramatic. If you have a case where the injury or event COULD have produced a head trauma or a brain injury, and a medical history suggesting that your client is experiencing difficulties, look closer at the possibility of a hidden brain injury. Impact to the case and for the client is significant. There are a lot of checklists, but here is one that can be helpful:
Yes_____ No_____ Reduced attention and concentration
Yes_____ No_____ Memory problems
Yes_____ No_____ Decreased frustration tolerance
Yes_____ No_____ Easily angered
Yes_____ No_____ Anxiety
Yes_____ No_____ Overreaction to events
Yes_____ No_____ Depression
Yes_____ No_____ Decreased emotional responsiveness
Yes_____ No_____ Reduced reasoning and problem solving
Yes_____ No_____ Difficulty following directions
Yes_____ No_____ Misunderstanding what is said by others
Yes_____ No_____ Impulsive or inappropriate social behavior
Yes_____ No_____ Reduced judgement
Yes_____ No_____ Decreased insight into self and others
Yes_____ No_____ Difficulty establishing and maintaining relationships
Yes_____ No_____ Difficulty on the job or at home
Yes_____ No_____ Headaches
Yes_____ No_____ Nausea
Yes_____ No_____ Dizziness/balance problems
Yes_____ No_____ Muscle weakness
Yes_____ No_____ Numbness and tingling
Yes_____ No_____ Fatigue or difficulty sleeping
Yes_____ No_____ Blurred vision
Yes_____ No_____ Ringing in ears
If your client is experiencing a number of these problems, or family members suggest there are problems, a complete evaluation by a team of experts is warranted. I typically set up IMEs with neuropsychology, neurology, ENT, Occupational Medicine, and Vocational Psychology–and share reports from each with all the others. ENT typically performs ENG and ABR testing to determine if problems are coming from a central (brain injury) cause. Neuropsychology performs a wide battery of testing to determine cognitive function and loss. Be sure you ask for a GAF score (see previous blog posts about this). Neurology helps document status and future treatment. Occupational Health gives a global overview, provides restrictions based on physical and emotional factors, and discusses ability to perform essential functions of work. Finally, the Vocational Psychologist and/or Evaluator provides opinion on ability to return to work, transfer into new work, or remains unable to be employed.
