Category: Uncategorized

By Karen Hayes

When it comes to legal matters, it is always wise to consider all potential risks and protect yourself from unexpected costs. After-the-event (ATE) insurance is one such option that could offer you financial protection in the event of a legal dispute. In this blog post, we will delve into the details of ATE insurance, its benefits, and whether it’s something you truly need.

What is After-the-Event Insurance?

After-the-event insurance is a type of legal expenses insurance that you can purchase after an incident has occurred and legal action is being taken. It provides coverage for legal costs, court fees, and other expenses associated with pursuing or defending a legal claim. ATE insurance is typically used to protect individuals from the financial burden of legal proceedings, especially when the outcome is uncertain.

Qualified One-Way Costs Shifting (QOCS)

Prior to the 6th April 2023, if an offer to settle (Part 36 Offer) was made by the Defendant but was not accepted by the Claimant, and at Trial the Claimant failed to beat that offer, then the consequences could be quite serious. For although the Claimant had technically won the case by proving the Defendant was at fault, they would have to pay from their damages the amount of costs incurred by the Defendant since the offer had expired (i.e after 21 days).  This could mean all the Claimant’s damages could be lost in paying the legal costs of the Defendant.

Regrettably, since the 6^th April, the possible consequences of such a situation have become even worse. Now the Court can award the Defendant’s costs from the Claimant’s damages and also from their costs.  This means if you do not have After the Event Insurance to protect you, then you could be left not only with no damages, but also a bill for your Solicitor’s costs if you fail to beat a Part 36 Offer.

It appears that it would be better for a Claimant to lose a claim in its entirety, rather than just failing to beat an offer.  This is because with QOCS, if there is no finding of fundamental dishonesty or fraud against the Claimant, if they simply lose the claim, then the Defendant will not be able to recover their costs.  Further, under the No Win No Fee Agreement, your solicitor would simply write off their costs as you had not ‘won’.

Benefits of After-the-Event Insurance:

1. Financial Protection:

Legal disputes can be expensive, with costs piling up quickly. ATE insurance helps mitigate the financial risk by covering legal fees and other related expenses, giving you peace of mind during a potentially stressful time. This means that if you followed your Solicitor’s advice and rejected a Part 36 Offer and then failed to beat it at trial, the ATE insurer would pay the Defendant’s costs.  As such, you would still retain your damages, enabling you to pay a contribution to your legal fees in accordance with the No Win No Fee Agreement.

2. Access to Justice:

ATE insurance can help level the playing field, ensuring that individuals or smaller entities can pursue legal action against larger opponents without fear of prohibitive costs.

3. Risk Management:

Legal cases can be unpredictable, and outcomes are never guaranteed. ATE insurance safeguards you against the possibility of having to pay your opponent’s legal costs.

4. Confidence in Pursuing Claims:

With ATE insurance, you might feel more confident in pursuing a claim or defending yourself in court, knowing that your financial interests are protected.

Do You Really Need After-the-Event Insurance?

While ATE insurance offers significant advantages, it might not be necessary in every situation. Here are some factors to consider when deciding if you need ATE insurance:

1. Nature of the Legal Dispute:

Evaluate the complexity and potential costs of your legal case. If it is a straightforward matter with low costs involved, ATE insurance might not be essential.

2. Financial Capability:

Assess your ability to cover legal expenses out of pocket. If the potential costs could jeopardise your financial stability, ATE insurance might be a prudent choice.

3. Opponent’s Resources:

Consider the financial strength of the opposing party. If they have deep pockets and can afford a prolonged legal battle, ATE insurance can provide a safety net for you.

4. Legal Advice:

Consult with Coulthursts to get their professional opinion on whether ATE insurance is recommended for your specific case.

Conclusion:

After-the-event insurance can be a valuable tool to protect yourself from unexpected legal costs and provide you with the confidence to pursue a legal claim. While it might not be necessary for every situation, its benefits are worth considering, especially if your case involves significant financial risks. To make an informed decision, carefully evaluate the nature of your legal dispute, your financial circumstances, and seek advice from Coulthursts. We can ensure you have the best After The Event Insurance protection possible to support you with your brain injury claim.

For our terms of use and disclaimer follow this link: https://coulthursts.co.uk/legal-terms-of-use/

By Karen Hayes

When someone lacks capacity to make decisions for themselves, whether due to age, illness, or disability, it becomes necessary to appoint a deputy to handle their affairs.  A deputy is responsible for making decisions on behalf of the person, managing their finances, and ensuring their well-being. This is especially relevant for people who have suffered a Traumatic Brain Injury (TBI) as it can have a particularly debilitating effect on their quality of life which, in many cases, can be permanent.

One of the most important decisions to make when appointing a deputy is whether to choose a family member or a professional.  To help you make an informed decision, here are some of the factors to consider when making this choice.

Understanding the role of the Deputy

Before considering who is the best person to act, it’s crucial to have a clear understanding of what a deputy does.  A deputy acts in the best interest of the individual who lacks capacity, making decisions that align with their values and preferences.  The duties of a deputy typically include managing finances, arranging care services, making healthcare decisions, and ensuring that the person’s daily needs are met.

Choosing a family member as Deputy:

Selecting a family member as a deputy often comes with a level of trust and familiarity that can provide comfort to the individual who lacks capacity.  Family members may have an intimate understanding of their loved one’s wishes, making it easier to make decisions that align with their best interests. Again, this is particularly relevant when helping someone with a TBI because closest relatives are not only affected by the person’s debilitation, but are also likely to be responsible for providing most day-to-day care.

Family members are also more likely to have a deep emotional connection with the person who lacks capacity.  They may be more attuned to their needs, preferences, and values allowing them to make decisions that prioritise their well-being.

Appointing a family member can also be cost effective.  Unlike professional deputies who charge fees for their services, family members may be willing to take on the role without expecting financial compensation.

Choosing a Professional Deputy:

By choosing a professional deputy, you know the person possesses the necessary knowledge and experience in managing complex financial and legal matters.  They are well-versed in the legal responsibilities associated with the role and can navigate intricate legal matters with ease.

Professional deputies can also provide unbiased perspective when making decisions, free from personal emotions or conflicts of interest.  This impartiality ensures that decisions are made solely in the best interests of the individual who lacks capacity.

Another advantage of having a professional deputy is that family dynamics can change over time.  However, professional deputies offer continuity and stability.  They are dedicated to their role and can provide consistent support, especially in situations where family members may be unable or unwilling to fulfil the responsibilities of a deputy.

Family Member or Professional.  Which is the best choice?

To decide whether a family member or professional deputy should be appointed, the individual circumstances of the person who lacks capacity should be considered.  Their needs, the complexity of their financial and legal affairs, and the availability of family members should all be considered in making this decision.

It is also essential to consider the dynamics and relationships within the family.  Conflicts or strained relationships among family members may hinder effective decision-making and potentially lead to disputes.

In some cases, it may be beneficial to appoint a combination of family members and professionals as deputies.  This can allow for a balance between the emotional connection to family members and the expertise of professionals.

Choosing between a family member and a professional deputy is a decision that should be made carefully, taking into account the specific circumstances and needs of the individual who lacks capacity.  There is no one-size fits all answer and the best choice may vary from case to case.  It is crucial to evaluate the trust, expertise, objectivity, and continuity offered by both options to ensure the well-being and best interests of your loved one.

Coulthursts, the only UK legal firm to specialise in TBI and to fund up front care for clients while pursuing their claim for damages, is ideally placed to provide you with expert advice on the subject of choosing the right deputy for your injured relative.

If you wish to consider becoming a deputy for your loved one, further information on the responsibilities and the procedures that must be followed, are provided at https://www.gov.uk/become-deputy

For our terms of use and disclaimer follow this link: https://coulthursts.co.uk/legal-terms-of-use/

By Karen Hayes

Head injuries have a wide range of effects on an individual’s health, and one common symptom that can arise after such an injury is blurred vision which can significantly impact a person’s quality of life and ability to perform daily tasks. If you or a loved one are experiencing blurred vision after a head injury that was caused by someone else’s negligence or wrongdoing, you may be entitled to compensation.  In this blog, we will discuss the importance of seeking legal representation from a skilled solicitor who specialises in head injury cases to ensure you receive the treatment and compensation you deserve.

Understanding Blurred Vision After A Head Injury

Blurred vision is a common symptom that can result from various types of head injuries, including concussions, traumatic brain injuries (TBIs) and other forms of head trauma.  It occurs due to disruptions in the visual pathways to the brain or damage to the optic nerve or structures around it, resulting in an inability to focus properly.  Blurred vision can range from mild blurriness to complete loss of vision in severe cases.  It can be temporary or permanent, and its impact on a person’s life can be substantial.

The Role of a Head Injury Solicitor

When pursuing compensation for blurred vision after a head injury, it is crucial to have a solicitor who specialises in head injury cases by your side.  Coulthursts is the only UK firm which specialises in brain injury claims and we understand the medical and legal complexities involved in such cases.  Here is how we can assist you:

1. Expertise

We will use our experience to assess the extent of your blurred vision and how it has impacted your life.  We shall instruct an ophthalmologist to undertake a comprehensive eye examination and they will assess the changes that you have experienced after the head injury. A CT scan or MRI may also be required to identify any soft tissue or bone damage that could be the cause of the blurred vision.  Once we have established the cause, we can then offer a bespoke Rehabilitation & Support Service to help you receive the best treatment possible to aid your recovery.  The treatment you receive will depend on the nature and severity of the injury.  All our solicitors have low caseloads, so they can spend the time necessary to support you and your loved ones at this stressful time.

2. Build a strong case

We will gather your medical records, test results, and expert opinions to build a compelling case that demonstrates the connection between your head injury and your blurred vision.  This may involve consultations with neurologists, ophthalmologists and other specialists.

3. Calculating Compensation

Determining the appropriate amount of compensation for your case can be complex.  Coulthursts Solicitors will take into account factors such as medical expenses, ongoing treatment costs, lost wages and the emotional toll of your blurred vision when calculating your claim.

4. Negotiation with Insurance Companies

Insurance companies may try to settle for a lower amount than you deserve.  An experienced solicitor will negotiate on your behalf to ensure you receive a fair settlement that covers all your present and future needs.

5. Litigation

If a fair settlement cannot be reached through negotiation, Coulthursts will take your case to court.  They will advocate for your rights and present your case effectively to a Judge to decide the value of your claim.

Conclusion

Blurred vision following a head injury can be a distressing and life-altering experience.  If your injury was caused by someone else’s negligence, seeking compensation is not only your right but also essential for your recovery and well-being.  To ensure the best possible outcome, it is crucial to consult with a head injury solicitor with a proven track record of handling similar cases.  With our expertise, Coulthursts can help you and your loved ones navigate the legal process with confidence and we will work to ensure you receive the compensation you deserve while you focus on your recovery.

For our terms of use and disclaimer follow this link: https://coulthursts.co.uk/legal-terms-of-use/

In the legal world, when pursuing a claim or lawsuit, it is essential to understand the concept of interim payments. Interim payments are advances against the final compensation amount. They can provide crucial financial support to claimants during the litigation process, ensuring they can cover immediate expenses an ongoing costs. Coulthursts solicitor Karen Hayes explains…

1. What are interim payments?

Interim payments are partial payments made by the defendant to the claimant during the course of legal proceedings. These payments are made before the final resolution of the claim, providing the claimant with financial support and helping to alleviate any immediate financial hardships.

2. Purpose and benefits of injuring payments

Interim payments serve to support claimants who may be facing financial difficulty as a result of the accident or injury. The aim is to help achieve fairness by ensuring that the claimant is not unduly burdened by financial constraints while awaiting the final resolution of the claim.

They can help fund rehabilitation, care packages or a house purchase, depending on the needs of the individual claimant.

3. Eligibility and Process

If court proceedings haven’t been started, then a request in writing is usually made to the defendant’s insurance company. In practice, evidence is supplied to justify a request for an interim payment. This could be an immediate needs assessment, carried out to recommend a package of measures, to help a claimant, who has suffered injury. However, there is a balancing act in relation to disclosing this needs assessment at an early stage, as it gives the insurance company information about the claimant ‘s injuries and possibly financial difficulties. By providing the report, the defendants could consider the potential value of the claim and make a pre-medical offer that could pose a risk for the claimant and potentially undervalue the entire claim.

If the Defendant refuses to release an interim payment, despite liability not being an issue, then Court proceedings can be started.  Then, an application to the Court can be made, to force an unwilling Defendant to release funds for the claimant’s needs.   The Court will consider the evidence and the potential value of the whole claim when determining whether an interim payment should be released.  This is to prevent overpayment to the claimant.  However, by issuing proceedings too soon to obtain an interim payment, the Court then becomes involved in all aspects of the claim, providing deadlines and may limit evidence.

4. Coulthursts solution to the problems surrounding interim payments

We seek to collaborate with Defendant insurance companies when it in our client’s interest to do so.  However, we require assurances that early offers are not made before releasing any evidence to ensure that full medical evidence is obtained in due course, so the claim can be valued fully.

If the Defendants will not release an interim payment, Coulthursts are the only firm to fund our client’s rehabilitation package to ensure the client doesn’t delay in receiving the necessary treatment.  Further, it prevents court proceedings being issued too soon, which can limit what we can do and when we can do it.  We protect our clients from the potential negative outcomes surrounding interim payments.

Author:  Karen Hayes who is a brain injury solicitor with more than 20 years’ experience.  Read more about Karen here

For our terms of use and disclaimer follow this link: https://coulthursts.co.uk/legal-terms-of-use/

A study by medical experts at a British university suggests that neuro inflammation, which occurs in people’s brains within minutes of suffering Traumatic Brain Injury (TBI), can facilitate neuro repair but can also contribute to secondary brain damage.

The research, by scientists at Birmingham University, has been focusing upon what is being described as the “golden hour” immediately after a head injury takes place when early identification of biomarkers can enable doctors to recognise and treat those patients most at risk of secondary injury while they are still capable of responding to therapy and before irreversible brain damage occurs.

The university’s TBI group, which carries out research linked with the activity of the National Institute for Health and Care Research (NIHR), is using ground breaking technologies to search for early signs of brain damage in patients before it becomes irreversible and to identify those patients most at risk of a poor cognitive outcome or of other mental health disorders. This not only allows the development of targeted and personalised treatment to suit individual patients, but can also be used to provide ongoing care for people most at risk of repeated TBI such as sports men and women, soldiers and the elderly.

The research programme, which involves a number of different academic disciplines including medicine, sports sciences, bioengineering, psychology, chemistry and computing,  is not the only research into TBI being carried out at Birmingham University. A team, led by Professor Antonio Belli at the University’s College of Medical and Dental Sciences, has identified inflammatory biomarkers which indicate whether the brain has suffered injury.

The team is trying to use them to develop a test that can be used on the side of a sports pitch or by paramedics to detect brain injury at the scene of an incident. Inflammatory markers are particularly suited for biomarker discovery because TBI leads to very early alterations in inflammatory proteins and this study has been funded by the National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre.

Dr Lisa Hill, of the University’s Institute of Inflammation and Ageing, said: “Early and correct diagnosis of traumatic brain injury is one of the most challenging aspects facing clinicians. Being able to detect compounds in the blood, which help to determine how severe a brain injury is, would be of great benefit to patients and aid in their treatment.”

A third study carried out at the university has found that patients with traumatic brain injuries face a high risk of suffering a stroke in the four months following injury and this remains significant for up to five years afterwards. This review, which brought together 18 studies from four countries, is the first of its kind to investigate post-injury stroke risk.

Funded by the National Institute for Health Research’s Surgical Reconstruction and Microbiology Research Centre based at University Hospitals Birmingham NHS Foundation Trust, the review showed that TBI patients have an 86% increased risk of stroke compared with patients who have not experienced a TBI.

Significantly, the findings suggest that TBI is a risk factor for stroke regardless of the severity or subtype of the injury. This is thought to be particularly noteworthy because 70% to 90% of TBI’s are mild and suggests that a TBI should be considered a chronic condition even if it is mild and the patient recovers well.

The researchers also found that the use of anti-coagulants, such as VKA’s and statins, could help to reduce stroke risk post-TBI, while the use of some classes of anti-depressants are associated with increased stroke risk post-TBI.

For our terms of use and disclaimer follow this link: https://coulthursts.co.uk/legal-terms-of-use/

Brain injuries can have profound and lasting effects on an individual’s physical, cognitive, and emotional well-being. One often overlooked consequence of brain injuries is their impact on the auditory and vestibular systems, which play a crucial role in maintaining balance, spatial orientation, and overall sensory perception. In this blog, we delve into the realm of audio vestibular treatment, shedding light on its significance in helping those with brain injuries regain control over their lives.

Understanding Audio Vestibular Treatment:

Audio vestibular treatment is a specialised therapeutic approach, that addresses issues related to hearing, balance, and spatial awareness. It encompasses a range of interventions aimed at mitigating the challenges faced by individuals who have sustained brain injuries. These treatments are designed to optimise the function of the auditory and vestibular systems, ultimately improving the quality of life for those affected.

Benefits of Audio Vestibular Treatment for Brain Injury Survivors:

1. Restoration of Balance:

Brain injuries can disrupt the delicate balance mechanisms within the inner ear, leading to dizziness, vertigo, and difficulties with coordination. Audio vestibular treatment employs a variety of exercises and techniques to retrain the brain and inner ear, facilitating the restoration of balance and reducing the risk of falls.

2. Enhanced Spatial Awareness:

Impaired spatial awareness is a common issue for brain injury survivors, leading to difficulties in navigating and interacting with the environment. Through targeted therapies, audio vestibular treatment helps individuals re-establish a stronger sense of spatial orientation, improving their ability to move confidently and independently.

3. Auditory Rehabilitation:

Brain injuries can affect auditory processing and lead to hearing problems. Audio vestibular treatment includes strategies to enhance auditory perception and processing, aiding in the interpretation of sounds and speech.

4. Reduced Sensory Overload:

Many brain injury survivors experience sensory overload, where normal stimuli become overwhelming. Audio vestibular treatment incorporates techniques to help individuals adapt to sensory stimuli, reducing distress and promoting emotional well-being.

5. Cognitive Benefits:

The auditory and vestibular systems are closely connected to cognitive functions such as attention, memory, and problem-solving. Audio vestibular treatment can indirectly enhance these cognitive abilities by optimising sensory inputs and their integration within the brain.

6. Improved Quality of Life:

By addressing the challenges posed by brain injuries, audio vestibular treatment empowers individuals to engage more fully in daily activities, participate in social interactions, and experience an improved overall quality of life.

Legal Considerations:

In cases where brain injuries have resulted from accidents or incidents caused by negligence or wrongdoing, individuals may be entitled to compensation. It’s essential to consult with experts who specialise in personal injury cases related to brain injuries. Coulthursts can help assess the circumstances, gather evidence, and navigate the legal process to ensure that brain injury survivors receive the support and compensation they deserve.

Audio vestibular treatment offers a ray of hope for individuals grappling with the aftermath of brain injuries. Its multidimensional approach, focusing on balance, spatial awareness, and auditory rehabilitation, can significantly enhance the lives of those affected. By understanding the importance of audio vestibular treatment and seeking appropriate legal assistance from Coulthursts, brain injury survivors can take crucial steps toward rebuilding their lives and securing a brighter future.

Author:  Karen Hayes who is a brain injury solicitor with more than 20 years’ experience.  Read more about Karen here

For our terms of use and disclaimer follow this link: https://coulthursts.co.uk/legal-terms-of-use/

Britain’s leading police officer for preventing road deaths believes that cyclists should wear head cameras to deter dangerous motorists because the evidence this would provide would enable the police to successfully prosecute lawbreakers threatening their safety.

Detective Chief Superintendent Andy Cox, formerly the most senior road safety officer with the Metropolitan Police and now the National Police Chiefs’ Council lead for fatal collision investigation reporting, said it would make cyclists what he called “part of the road danger solution” because police could not solve the problem on their own.

He made the announcement when he tried to raise awareness of the issue as he cycled 30 miles around central London with the campaigning BBC broadcaster, Jeremy Vine, who is well-known for recording near misses he has with motor vehicles while cycling to work in the capital[1].

His statement provides welcome support for all of us at Coulthursts as we are the leading brain injury lawyers specialising in winning compensation for people who have life changing Traumatic Brain Injury (TBI) issues. We have always made it clear that although not necessary for pursuing a claim for damages, the existence of head cam footage can greatly enhance the likelihood of a successful outcome.

It also comes at a time when the Government is actively pursuing a policy of encouraging more people to travel by cycle and on foot to enhance their health and well-being and as part of the fight against pollution and global warming.

It is aiming to make cycling and walking the preferred mode of transport for all journeys under five miles by 2040. At the same time, its framework, Active Travel England, envisages that half of all journeys in towns and cities will be walked or cycled by 2030.

The Government’s aspirations in this direction have been helped by the cycling converts who turned to self-power transport during the Covid lockdown as a legal way of escaping from the constraints of their homes and discovered that they rather liked the freedom of peddling down the open road.

The post-pandemic popularity of cycling is quite marked. In England, there were almost 6.5 million regular cyclists by 2021 – a rise of more than 28 per cent compared with five years previously.

Other parts of the United Kingdom also recorded increases, though of a rather more modest level. During roughly the same period, the percentage of people from all age groups in Scotland increased from 10.3 to 12.8 and in Northern Ireland from 12 per cent to 18 per cent. Respondents to a smaller sample in Wales revealed that 4 per cent of them cycled at least once a week for genuine travel purposes.

Government figures from 2014-16 showed that 9.5 per cent of adults each claimed to cycle at least 53 miles a year. By 2019-20, the average yearly distance travelled by each cyclist had increased to 88 miles per year.

In addition, the Government’s National Travel Survey showed that 47 per cent of people in England had access to a bike in 2020 and many of the new converts have remained as committed cyclists. This is supported by the fact that the UK spent £514 million on cycles during 2022 compared with only £390 million in 2018.

However, there is a downside. As cycling has increased in popularity, so have the accidents involving cyclists and they make bleak reading. Latest statistics show that more than 100 cyclists are killed and more than 4,000 are seriously injured every year, 56 per cent of cyclist fatalities occur on rural roads and the biggest single cause of cyclist casualties of all sorts is when they are wearing dark clothing and cannot be seen properly[2].

It is therefore a sobering thought that, according to The Brain Charity, 45% of British cyclists admitted to riding without a helmet even though wearing one could reduce the risk of brain injury. The body has now teamed up with a cycle gear manufacturer to draw attention to the danger[3].

Lightweight cameras are available for as little as £26 and it is also advisable to have  rear facing and forward facing cameras mounted on the cycle to catch shots which do not occur in an area where the cyclist does not happen to be looking at the time[4].

The matter has never been more important than it is now as the Government has been quick to latch onto new cycling converts as an important part of its drive towards a greener travel landscape.

Against such a background, there has never been a better time for cyclists wearing helmets and head cams to be as natural and common as motorists and their passengers wearing seatbelts.

For our terms of use and disclaimer follow this link: https://coulthursts.co.uk/legal-terms-of-use/

[1] https://www.standard.co.uk/news/uk/cyclists-wear-headcam-deter-dangerous-drivers-police-jeremy-vine-b1002004.html

[2] www.provizsports.com/en-gb/blog/uk-cycling-statistics/

[3] https://www.thebraincharity.org.uk/endura-bike-helmets-project-heid/

[4] www.cyclingweekly.com/group-tests/bike-helmet-cameras-327336#Cycling%20Safety%20Camera

According to NHS inform, concussion is the “sudden but short-lived loss of mental function that occurs after a blow or other injury to the head”[1]. It adds that concussion is “the most common but least serious type of brain injury” and that “…the medical term for concussion is minor traumatic brain injury”.

So whilst a concussion is sometimes perceived to be an almost innocuous occurrence – the kind we usually associate with a sports field injury or an assault, or road traffic accident – the reality can be very different.

For, as indeed NHS inform attests to, a concussion is very much a traumatic brain injury. And even if ‘minor’ (or ‘mild’ as is the common term), the consequences can still be devastating for those that do not recover quickly.

Indeed, the effects of a concussion aren’t always immediately evident, and instead can gradually develop over time, with the person concerned not realising that they are suffering from it.

The signs are there but people often do not recognise them, particularly if they have been in an accident or incident, may be in pain and/or on medication. In fact, patients could be suffering from a range of over two dozen symptoms, including headaches, fatigue, poor memory, poor concentration, light sensitivity, sadness, anxiety, getting easily irritated, dizziness and even feeling worn out after a good night’s sleep.

And if their injury has been caused by a third party – for example, in the case of an accident, violence or even a fall – then it would also be advisable to seek legal advice from a specialist in cases involving Traumatic Brain Injury (TBI), and ideally with a speciality in concussion.

“Even though someone may have had a brain scan after an impact or violent shake to their head and no bleed has been found, they may still have suffered a concussion as concussions cannot be seen on a brain scan,“ explains Philip Coulthurst, MD of the specialist brain injury lawyers Coulthursts.

If you have been examined for concussion and your symptoms worsen, or if you later become aware of further symptoms – including those that make you feel nauseous or affect your thinking processes, or if you have worsening headaches, dizziness, problems with balance, slurred speech, loss of consciousness, sleepiness, weakness (and many other possible symptoms besides) – then you should return to A&E immediately. Note: You should have been given a head injury advice leaflet at A&E,  which among other things will advise you when you should return to A&E. It is important you follow the advice you have been given by any doctor.

Conversely, if you did not receive a head injury advice leaflet, then you should be able to find information online from the hospital you went to, but always err on the side of caution. You can also ring NHS 111 if you are unsure what to do and there are many useful sources of information to be found online, including this leaflet from Imperial College Healthcare NHS Trust – https://rb.gy/g1hwii

“Most people recover quickly from a concussion or head injury, but a significant minority, particularly those whose injury was severe enough to go to hospital, do not,” adds Coulthurst. “Often, they can go on to suffer ongoing persisting symptoms.”

A concussion is clinically known as a mild TBI, although in the UK the words concussion and head injury are more commonly used. In fact, around 90% of those attending A&E with a head injury are classified as a concussion or mild head injury.

“Most concussions occur without a loss of consciousness,” explains Coulthurst, “yet, for those who do not fully recover, this can be anything but mild and can affect a person’s day-to-day life, including their personal relationships and ability to work.”

Indeed, according to one study, it “…is becoming clear that ‘mild’ is indeed a misnomer for this disease, because many patients experience significant and persistent symptoms. For these patients, mild Traumatic Brain Injury [Concussion] is anything but mild.”[2]

“The challenge with this is that it can then be extremely difficult to access healthcare and treatment for those who suffer ongoing problems following a concussion,” concludes Coulthurst, “and treatment can often be limited to focusing on one symptom or issue such as headaches or emotional problems.”

“As part of our service when representing clients, we are often able to help secure access to the best treatment and rehabilitation for concussion, mild TBI and post-concussion syndrome, and our focus is to do this as soon as possible and often long before any claim is settled. This helps to ensure that the necessary treatment, which our clients would often struggle to secure any other way, is not only delivered, but also at the time they need it most.”

“So, if you, or someone you know, may still be suffering symptoms from a concussion or mild TBI, then please get in touch.”

[1] https://www.nhsinform.scot/illnesses-and-conditions/injuries/head-and-neck-injuries/concussion#:~:text=Concussion%20is%20the%20sudden%20but,is%20minor%20traumatic%20brain%20injury.

[2] McMahon et al 2014 – Symptomatology and Functional Outcome in mTBI: Results from the prospective TRACK_TBI Study

For our terms of use and disclaimer follow this link: https://coulthursts.co.uk/legal-terms-of-use/

As many as half of all Traumatic Brain Injuries (TBIs) are believed to be caused by road traffic accidents (RTAs). But many of those injured are unaware they may have a case for support and compensation. What can be done to ensure injured parties get the support they need?

According to the best estimates available, some 1.4 million people attend hospital every year with a TBI¹, and 160,000 of those then go on to be admitted for a longer stay. However, a significant proportion of people who sustain a TBI in a road traffic accident are thought to be missing out on compensation to which they are entitled, simply because they do not think they have a case.

The casualties slipping through the net include those who are partly at fault for the accident in which they were involved, or who are related to the person at fault. Others who mistakenly think they cannot make a claim, are those injured by a driver not subsequently prosecuted by the police, or who were in a crash with an uninsured driver or unknown driver. The injured party in all these scenarios could still be entitled to compensation to help them rebuild their lives.

According to the RAC Foundation, by September last year there were 40.8 million licensed vehicles on the UK’s roads, including 33.2 million cars, 4.1 million vans, 1.5 million motorcyles, 500,000 HGVs, and 150,000 buses and coaches². On top of this there are also an unknown number of cycles and, of course, pedestrians. With all these different users sharing our crowded roads, it is therefore unsurprising that accidents happen.

In fact, someone is killed or seriously injured on UK roads every 16 minutes³, and there are thought to be a number of reasons why road traffic accident (RTA) rates remain consistently high:

· The driver or rider failing to look properly (37%)

· The driver or rider failing to judge the other person’s path or speed (19%)

· The driver or rider acting recklessly, hurried driving or speeding (16%)

· A poor turn or manoeuvre (12%)

· Loss of control (11%)

And whilst there have been considerable advances in vehicle technology, the likelihood of head injuries at speeds in excess of 10 mph remains high.

A TBI is usually caused by an impact to the head. This external force can cause a focal injury to the brain. An impact to the head, or if the head is violently shaken without any impact, can also cause what is known as an acceleration/deceleration injury. This is where there is a sudden violent movement of the head causing the brain to move and rotate inside the skull. These can cause bruising (contusion) to the brain and trauma to the blood vessels causing bleeding (hematoma or haemorrhage). Contusions and Bleeds will usually be seen on head scans; however, an acceleration/deceleration injury can cause the shearing or stretching of the nerve fibres (axons) inside the brain which are microscopic and unlikely to be visible on a brain scan. Concussions and those labelled a ‘mild head injury’ are also unlikely to be seen on any scan but can cause ongoing symptoms for some which can have significant consequences– see our blog on concussion.

The risk of TBI also depends on road user type (i.e. car, motorbike, bicycle or pedestrian), the speed of impact and the direction of impact. The higher the speed, the greater the impact on the skull and the brain. Research has shown that the risk of brain injury triples when the impact velocity is doubled.

Brain injury is also more likely in cars involved in side impacts, or where the change of speed is greater, like during a head-on collision. It is also more likely in vulnerable road users, especially where no head protection is worn, with pedestrians and cyclists six times more likely than car occupants to suffer moderate to severe brain injury on the roads.

The Office for National Statistics also gives us the following information relating to non-car road traffic accidents:

· Pedestrians – there are more than 700 pedestrian deaths, and 7,000 injuries annually

· Motorbikes – there are more than 600 motorbike deaths and almost 7,000 injuries annually

· Cycling – there are approximately 120 deaths and more than 2,000 injuries annually

Sadly, suffering from a TBI can be life changing, even if initially considered to be on the ‘mild’ end of the scale. It is therefore crucial to seek out specialist legal advice as soon as possible, even if you fear you may not have a case for compensation.

At Coulthursts, we are unique as a law firm in that we provide a joint legal and rehabilitation approach. We can will pay for and coordinate treatment and rehabilitation at the earliest opportunity, to give our clients the best chance of making the best and quickest recovery from their brain injury. At the same time, we deal with the legal claim and fight to obtain the best possible compensation. We also pride ourselves in providing support to the whole family and not just the injured individual.

Please do not hesitate to contact us to discuss your accident at no cost or obligation.

¹ https://emj.bmj.com/content/39/3/233
² https://www.racfoundation.org/motoring-faqs/mobility#a1
³ https://www.brake.org.uk/get-involved/take-action/mybrake/knowledge-centre/uk-road-safety

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Returning to work is one of the main benchmarks of recovery and of overall well- being following a brain injury.

Therefore, a major review of 101 studies exploring relturn to work rates after a mild traumatic brain injury (mTBI) provides a valuable insight into what supports recovery and what are the main predictors of a delayed or non-return to work.

What do the studies tell us about likelihood of return to work after a brain injury?

Three of the four studies suggest most workers with MTBI do return to work. For example, one study showed 76% of participants (152 of 201) were fully back at work six months after their original injury. Another study, which included individuals making legal claims for their injury, found 72 per cent of people were back at work after 72 days. However, five per cent had not returned to work and were full time unemployed two years after their injury. A fourth study reported more pessimistic outcomes: more than half the individuals with brain injuries had not returned to work six to nine months after the original injury. Overall, considering all of the studies reviewed, it was found that after a mTBI, around 5 to 20 per cent of injured workers face persisting problems and unable to return to work one to two years after their original injury.

What predicts problems with returning to work?

The review of 101 studies found there were a number of factors which predicted a stronger possibility of return to work. These included: having more than 11 years of formal education, absence of nausea or vomiting on hospital admission, absence of additional extracranial injuries, absence of severe pain immediately after injury. Younger individuals (aged 20 to 29 years) were more likely to return to work and there was no significant difference between genders. One study found that after an mTBI, people whose jobs had greater independence and scope for decision-making did better in terms of return to work than those with less. Student, homemaker, professional/semi-professional, and management categories were defined as occupations offering more independence and opportunity for decision making compared with the clerical, sales and service, manual labour and trades occupations. This echoes another study which individuals holding professional and/or managerial positions are three times more likely to return to work
than those in the manual labour occupations.

What does this mean in terms of support and rehabilitation for people with brain injuries?

The review provides a really interesting and valuable insight into what might support a good recovery and what might be risk factors for long term, disabling difficulties. There is a mixture of physical and social aspects; we might expect, for example, the presence of nausea and vomiting to be linked to increased risk of poor outcome and equally we might expect, for example, for younger individuals to do a little better in terms of returning to work. What stands out is the links between educational achievement prior to injury, occupational scope for independent decision making and type of occupation. It seems that there are a number of factors that make a person in a lower skilled, less independent job with lower prior educational attainment less likely to return to work after a brain injury. We already know the importance of a holistic and comprehensive support and rehabilitation approach to support best outcomes for each individual. This review suggests there is perhaps a need for this support to be more precisely personalised to meet the distinct challenges in certain job types and for older individuals. This might encompass, for example, an early focus on what the specific difficulties are and what support there could be and if needed, support to find an adapted role or even a move to a different job in order to mitigate against the debilitating prospect of failing to return to work and loss of confidence and capacity to work.

References

Systematic Review of Return to Work After Mild Traumatic Brain Injury: Results of the International Collaboration on Mild Traumatic Brain Injury Prognosis. Carol Cancelliere et al. Archives of Physical Medicine and Rehabilitation 2014;95(3 Suppl 2):S201-9.

Walker WC, Marwitz JH, Kreutzer JS, Hart T, Novack TA. Occupational categories and return to work after traumatic brain injury: a multicenter study. Arch Phys Med Rehabil 2006;87:1576-82.

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