Catastrophic Injuries—Traumatic Brain Injuries (TBIs) Post-Traumatic StressDisorders, and similar events—are a significant aspect of my practice. A catastrophic head injury usually involves an element of brain injury. Diverse questions therefore are raised regarding the injured person’s competence to manage funds as well as the need for caregivers, the prognosis, emotional impact/distress (on the individual as well as the family/network), level of chronic pain, the need for treatment, testamentary capacity and undue influence.
These assessments usually require the participation of other physicians or mental health professionals, such as neuropsychologists. As a rule, the assessment of a catastrophic injury is extremely time-consuming; the expert must be prepared and available to spend the necessary time to understand the dimensions of the case. Psychiatrists who only occasionally undertake forensic evaluations generally do not have either the experience in assessing a catastrophic injury or the time necessary to satisfactorily perform the assessment. Treaters commonly do not have the time available to work up such cases because their focus is on treatment and not on the forensic ramifications.
In catastrophic injury cases, the expert must be prepared to write a lengthy, comprehensive medical-legal report so that all parties can understand the dimensions of the case—emotional distress, prognosis, any likelihood that permanent disability will result, the need for treatment and its types and costs, including those for therapists, care and caregivers, medication, and long-term neuropsychological rehabilitation, and other relevant issues—to help the attorneys on both sides and the plaintiff understand the various needs of the plaintiff has and the financial consequences.