Diagnosing Brain Injuries – The Glasgow Coma Scale
Considering the brain’s complexity, it should come as no surprise that many diagnostic tools for suspected brain injuries share that high level of sophistication. Sometimes, though, a simple test performed immediately following an injury can shed a great deal of light on the situation. The Glasgow Coma Scale, helpful in determining the legal outcome of many traumatic brain injury claims, is just such a low-tech but valuable test.
Acquired brain injuries have gained notoriety as difficult claims to compensate properly. With so much money at stake and the serious long-term implications present in so many of these cases, every piece of medical evidence – including a score from the Glasgow Coma Scale – is scrutinized.
When emergency response workers arrive on the scene of an accident, they often use the Glasgow Coma Scale for an initial diagnostic of a victim’s head injury. The test, which can be administered by trained professionals in a variety of scenarios, examines three main areas to gauge the level of consciousness: motor response (such as obeying verbal commands), verbal response (such as the level of coherence in their speech) and eye opening (such as opening eyes on command).
The test administrator adds up the individual scores to reach a total between 3 and 15. In Ontario’s Statutory Accident Benefit Schedule for motor vehicle accidents, the Glasgow Coma Scale is used, in part, to determine which brain injuries give rise to a catastrophic impairment; an impairment which provides Medical , Rehabilitation and Attendant Care benefits that are increased dramatically.
Section one of Ontario’s Statutory Accident Benefits Schedule lists catastrophic impairment in cases of brain injury, in part, as a score on the Glasgow Coma Scale of nine or less according to a test administered within a reasonable period of time after the accident by a person trained for that purpose. A trained professional may administer the test a few times after an injury occurs, to see how it is progressing. In a precedent-setting brain injury case, Liu v. 1226071 Ontario Inc., the appeals judge found that repeated tests yielding increasingly higher numbers on the Scale as time passed should not nullify an initial higher score. In other words, despite the progress in recovery, the plaintiff’s injury should still be deemed catastrophic.
Several other issues have arisen as to the reliability of the Glasgow Coma Scale to determine the existence of a catastrophic impairment under the Schedule. Scores following intubation and scores involving accident victims who have been drinking alcohol have been called into question by insurers and their examiners. Therefore, even straightforward scores of nine or less may have to be litigated by a lawyer with extensive experience in this area. At Futerman Partners LLP, we have been handling catastrophic brain injury claims for over 30 years.