Hello, my name is Bennett Garfinkel. I am coming to you today from the Maitland law offices of Garfinkel and Schwartz that is a suburb of Orlando, in Central Florida.
I am not a physician, nor am I an attorney. Here at Garfinkel and Schwartz I am the medical and legal researcher. I am also the assistant to attorney Brian Wiklendt. I am here today to talk to you about an injury that multiple private military contractors and veterans are unfortunately all well too familiar with.
You may watch a video called, “Traumatic Brain Injuries Covered by DBA” on the Garfinkel Schwartz YouTube channel.
Bill Pascrell a New Jersey congressmen stated that traumatic brain injury is the signature injury of the wars in Iraq and Afghanistan.
Physiology, Anatomy, Diagnosis of TBI
Here, I am going to talk to you a little bit about the physiology, anatomy, diagnosis and treatment of traumatic brain injury. That is why I have here my model skull.
Inside the skull is the human brain. It is a fairly large object. I studied neurobiology and I have a degree in psychology from Rollins College. I’ve run a neurobiology lab at Rollins College for two years. So I have a little bit of undergraduate training in this.
I also have an emergency medical technician license. I also had time with Doctors without Borders volunteering as an acute trauma medic. In those situations I saw a lot of traumatic brain injuries.
The Brain Inside the Skull
While I am not a physician, I would like to talk to you a little bit about traumatic brain injuries. If you look at the inside of the skull you would see it is not a very smooth place. There are lots of very sharp corners and it is made out of bone so it is quite hard.
The brain is however almost the consistency of jelly. People do not usually think of the brain as jelly but the brain is mostly water like all the humans.
When the skull receives a traumatic hit what happens is the brain bounces, therefore causing bruising in the brain. Bruising of the brain is a severe traumatic injury and that is why it is called a traumatic brain injury.
If you have had a concussion that is classified as a mild traumatic brain injury. So for the classification of traumatic brain injury doctors and physicians use a couple scales.
Glasgow Coma Scale
The first is class Glasgow Coma scale. This looks at reactivity and how aware a person is of their surroundings after their major head injury.
Post Traumatic Amnesia
There is also something called post traumatic amnesia and that is when one loses their identity or not being able to form memories after the traumatic brain injury.
And then there is also loss of consciousness LOC which is something fairly simple. It’s what is if you have lost consciousness after the attack.
Mild TBI vs. TBI
In a mild traumatic brain injury someone loses consciousness for less than 30 minutes, they have post traumatic amnesia for less than 24 hours. That is why it is referred to as a mild traumatic brain injury and concussion.
The most common symptoms of a traumatic brain injury when it occurs is, besides the loss of consciousness and the posttraumatic amnesia, which is the loss of memories and the inability to make new memories after the head injury.
Orbital Frontal Cortex
The reason most of these symptoms are most common are two reasons. Again if you look at the skull you will see that the brain kept these two areas known as the orbital frontal cortex which is right here. And also the temporal lobe right here.
The most common symptoms after a head injury is vomiting, nausea, headache, being unable to form words, which is called aphasia. Those are just the median symptoms.
The areas I just showed you are responsible for the lesser symptoms of traumatic brain injury. And this is why traumatic brain injury can be such a huge cause of disability and difficulty in individual lives.
The orbital frontal cortex here is responsible for making complex decisions, making rational thought out decisions and those processes. An injury there would cause possible cognitive deficits. So maybe you do not feel as smart or as if words do not come as easily to you as they once did.
Also in the temporal lobe it is very important it processes emotion, it processes memory, and it processes spacial reasoning. Injury to the temporal lobe there traumatic brain injury can cause difficulties in all of those things I just mentioned.
So if one is having trouble with say, we have a client here that forgot where his keys were all of the time. We told him that was a good indicator to go to a physician and get some tests to see if you have any lasting damages from a traumatic brain injury because he suffered a head injury in an IED attack.
TBIs From IEDs and Blast Waves
We see a lot of traumatic brain injuries from IEDs and the blast waves. Then again caused the brain to bounce around in the skull. That same thing happens in falls when the skull hits a very hard object and the brain bounces back and forth in the skull. That can also hit the frontal lobes and the temporal lobes.
So the lasting reasons for TBI and that is the reason it is a significant injury. One can have social deficits, one can be quick to anger. A patient with traumatic brain injury can have spacial reasoning, forgetting where one’s keys are, emotion and memory problems.
Those are very significant problems with neurological injuries and it can be difficult to diagnose when someone has traumatic brain injury. After a patient receives a blow to the head the most common thing will be to get a CT scan.
Be Certain to Get a CT Scan to Know
A CT scan is simply an x-ray that gives you a 3D that sees the bruising on the brain. Often in Iraq or Afghanistan a CT scan is not available and will have the reports from the field medics which I understand because I was once one will report loss of consciousness will note if the patient is suffering from any amnesia and will see if the pupils response is any different or unusual.
Those are all signs of a traumatic brain injury. Once a private military contractor or a veteran comes back to the states they can receive better diagnosis and treatment for the traumatic brain injury.
This will include going to either a neurologist or a neuropsychologist. Everyone knows neurologists are brain doctors and brain doctors will look at all of the symptoms that I was talking about. Perform specific tests that are related to what part of the brain causes emotional reasoning, spacial reasoning, different types of judgment or memory problems they will sign specific tests to do that.
Some cultural neuropsychologist who has a degree in neuropsychology they will be able to assign the same test as well. This test may involve 15 minute standardized tests questionnaire, or a test that looks at memory.
Often times insurance companies will deny testing to private military contractors or DOD subcontractors who have suffered a head injury. The insurance company will deny the individual getting the testing to see if they actually have a traumatic brain injury.
Because of its lasting effects and its lasting disability, insurance companies often want to deny that. But here at Garfinkel and Schwartz we feel is very important to get the best medical care.
Personally, I have gone through five spinal surgeries. I have been lucky enough not to get a traumatic brain injury but I have been to a lot of neurologists and have had all those tests it can be a grueling process.
That is one of the reasons I feel very empathetic towards a lot of our clients because, I have gone through the difficult times. I feel, and here at Garfinkel and Schwartz, it is your job to get better.
It is your job to get the proper medical care. It is your job to get the proper diagnosis. What we will do is actually forward the cost of your exam with the neurologist or the neuropsychologist, to have you properly diagnosed with traumatic brain injury if you suffered a head injury over in Iraq or Afghanistan, wherever you were serving U.S. interests.
All Calls to Garfinkel Schwartz Are Confidential
For that reason it is a good idea to give us a call to discuss your case and again everything you say to us when you call is confidential. You will speak with either me or my lead attorney Brian Wiklendt about the merits of the case. About the legal intricacies of the law. I appreciate the time of you taking to listen to me talk about the brain.
If you have suffered a traumatic brain injury, or a head injury of any kind, and if you were a contractor working under a Department of Defense contract, you fall under the Defense Base Act.
At Garfinkel and Schwartz that is what we specialize in we work only in Defense Base Act and areas of litigation that fall under that. We are small, family-oriented firm.
I would like to say thank you for watching this video and hopefully we can get you some help.
Again my name is Bennett Garfinkel. I am not a physician. I am not an attorney. I have undergraduate training in psychology and neuropsychology and I was also a field medic with Doctors without Borders and saw some of these injuries.
I am coming to you from the Maitland offices here at Garfinkel and Schwartz. Thank you again for watching this video. I have also received medical training in the field of emergency medical technician.
I have an emergency medical technician license and I have also worked with Doctors without Borders in Central America. Here at Garfinkel and Schwartz I am the legal assistant and medical researcher on our cases. So what I do is often look through medical records concerning a head injury.
In this case look at the loss of consciousness, look at the post-traumatic amnesia, any notes from the field medic and help interpret them and apply them to your case. I work under lead counsel Brian Wiklendt and assist him in making sense of the medical jargon and what making these things a little more clear.