June 3, 2025 | Personal injury

Proving a traumatic brain injury (TBI) in a personal injury case can be one of the most challenging aspects of litigation. As experienced Omaha personal injury attorneys, we have encountered numerous cases where establishing the existence and severity of a brain injury required a meticulous and comprehensive approach. In this article, we’ll walk you through the essential steps and strategies to effectively prove a traumatic brain injury, based on years of legal practice and medical insights.

Understanding the Complexity of Traumatic Brain Injury

Traumatic brain injury is not a simple diagnosis. Unlike a broken bone or a visible wound, brain injuries often involve subtle and complex damage that cannot be easily detected through standard medical tests. The brain contains billions of neurons, and damage to even a small number of these neurons can result in significant cognitive, emotional, and physical impairments.

One of the common misconceptions, especially among insurance companies and defense attorneys, is that a concussion or mild traumatic brain injury is a temporary condition that resolves within a few months. However, current medical science tells a different story. Many individuals suffer lifelong consequences from TBIs, including memory loss, impaired executive functioning, and emotional disturbances that profoundly affect their quality of life.

The Importance of “Before and After” Witnesses

One of the most crucial tools in proving a traumatic brain injury lies beyond medical records and imaging studies. It is the testimony of what we call “before and after” witnesses or community witnesses. These are people who knew the injured person well before the injury occurred and can provide firsthand accounts of how the individual’s behavior, personality, and capabilities have changed since the incident.

Who Are These Witnesses?

• Family members: Spouses, parents, siblings, and children who observe the daily struggles and changes.
• Friends and neighbors: Individuals who interacted regularly with the injured person and can attest to alterations in social behavior or personality.
• Coworkers and supervisors: Those who can speak to the person’s work performance, memory, and executive functioning before and after the injury.

Collecting detailed biographical information and statements from these witnesses helps paint a vivid picture of the injured person’s life pre- and post-TBI. This narrative is often more compelling than medical jargon because it relates directly to how the injury impacts daily living and future prospects.

The Role of Medical Experts in Proving TBI

While community witnesses provide the human story, medical evidence is indispensable in substantiating the diagnosis and extent of brain injury. The key medical professionals involved in evaluating and proving TBI typically include:

1. The Neurologist – The Medical Lead

The neurologist usually serves as the primary medical expert overseeing the diagnosis and management of TBI. This specialist is familiar with the complexities of brain injuries and coordinates referrals to other experts as needed. In some cases, a physiatrist (a rehabilitation medicine physician) may also serve this role.

The neurologist performs a detailed clinical examination and decides which advanced neuroimaging techniques will best reveal the extent of brain damage. This expert’s testimony is critical in explaining the injury to judges and juries in a way that is medically credible and understandable.

2. Advanced Neuroimaging Techniques

Standard imaging tests such as CT scans often fail to detect subtle brain injuries like concussions or micro-hemorrhages. This is because CT scans provide relatively low-resolution images and may appear “normal” even when there is significant neuronal damage.

Some of the most effective neuroimaging modalities used in TBI cases include:

• 3T MRI: A high-resolution MRI that provides detailed images of brain structures. It can detect abnormalities not visible on standard MRI machines.
• Diffuse Tensor Imaging (DTI): A specialized MRI technique that maps white matter tracts and reveals microstructural damage to neuronal pathways.
• Functional MRI (fMRI): Measures brain activity by detecting changes in blood flow while the patient performs specific tasks. This helps demonstrate how the injury affects brain function.
• Positron Emission Tomography (PET) and Single Photon Emission Computed Tomography (SPECT): These scans provide color-coded images showing metabolic activity and blood flow in the brain, highlighting areas of dysfunction.

3. Neuropsychological Evaluation

Another vital component of proving a traumatic brain injury is the neuropsychological assessment conducted by a neuropsychologist. This expert administers a battery of cognitive, memory, attention, and executive function tests. The evaluation may span several days, with sessions lasting multiple hours each day. The neuropsychologist also interviews the patient to gather qualitative information about their symptoms and challenges.

The resulting comprehensive report is often a cornerstone of the case. It objectively documents cognitive deficits, emotional changes, and functional impairments directly linked to the brain injury. This report can be contrasted with the individual’s pre-injury baseline, as described by community witnesses, to demonstrate the injury’s impact.

Combating Insurance Company Skepticism

One of the biggest hurdles in proving TBI is overcoming the outdated and dismissive attitudes often held by insurance companies. They frequently portray concussions and mild brain injuries as minor, transient conditions that resolve quickly without lasting effects.

This narrative is not supported by modern medical research. Many TBI victims experience persistent symptoms that profoundly alter their lives, including:

• Memory loss and difficulty concentrating
• Impaired executive functioning such as planning and decision-making
• Emotional instability, depression, and anxiety
• Physical symptoms like headaches, dizziness, and fatigue

These symptoms often worsen over time rather than improve. Therefore, the legal strategy must emphasize the permanence and severity of the injury, backed by medical evidence and witness testimony.

Using Visual Aids to Explain Brain Injury

When presenting a TBI case in court, visual aids can be invaluable. Brain models that illustrate the different lobes and their functions help jurors and judges understand the complex nature of the injury.

For example, a physical brain model allows the attorney or expert witness to point out specific areas of damage and explain how those areas control memory, personality, motor skills, and other vital functions. This tangible demonstration bridges the gap between medical terminology and lay understanding.

Summary: The Comprehensive Approach to Proving Traumatic Brain Injury

To effectively prove a TBI in a personal injury case, you must combine several critical elements:

1. Detailed Client and Witness Interviews: Gather extensive “before and after” accounts from family, friends, coworkers, and others who witnessed the changes in the injured person’s life.
2. Expert Medical Evaluation: Secure a trusted neurologist or physiatrist who can coordinate care and recommend appropriate advanced neuroimaging studies.
3. Cutting-Edge Neuroimaging: Use high-resolution MRI, DTI, fMRI, PET, or SPECT scans to reveal brain damage invisible on standard tests.
4. Comprehensive Neuropsychological Testing: Obtain detailed cognitive and psychological assessments that document the injury’s impact on mental functions.
5. Effective Courtroom Presentation: Use visual aids like brain models and clear expert testimony to explain the injury’s nature and permanence.

This holistic approach not only strengthens your case but also ensures that the injured person’s story is fully told and fairly represented, leading to the best possible legal outcome.

Why Proper Documentation Matters for the Future

It is important to recognize that traumatic brain injuries often do not improve over time. In fact, in many cases, symptoms may worsen as the injured person ages or faces new challenges. This reality makes thorough documentation and early intervention critical.

Properly proving a TBI can secure compensation that covers:

• Medical treatment and rehabilitation
• Loss of income and future earning capacity
• Long-term care and support services
• Pain, suffering, and diminished quality of life

Without solid proof, injured individuals risk receiving inadequate settlements or outright denial of their claims. Therefore, investing time and resources into a comprehensive evaluation process is essential.

Final Thoughts

Proving a traumatic brain injury in a personal injury case requires more than just medical records or a diagnosis. It demands a thorough exploration of the injured person’s life before and after the injury, expert medical analysis using state-of-the-art technology, and compelling presentation to the court.

Insurance companies often underestimate the severity and permanence of TBIs, but with the right approach, you can demonstrate the profound impact on your client’s life. The goal is to ensure justice is served and the injured party receives the compensation they deserve to rebuild their life.

If you or someone you know has suffered a traumatic brain injury due to someone else’s negligence, it is crucial to consult with an attorney experienced in handling these complex cases.  Please call High & Younes LLC at 402-933-3345 for a case evaluation.

How To Prove a Traumatic Brain Injury