Brain injury litigation is among the most frequently disputed areas of neurological medico-legal work, and also among the most analytically complex. The diagnostic criteria exist, the imaging and neuropsychological literature are extensive, and the standard-of-care expectations are reasonably well-defined — yet most contested cases do not turn on whether injury occurred. They turn on severity, mechanism, timing, and the relationship between documented findings and reported impairment. Plaintiff and defense theories often rest on the same underlying record; the question is what the record can and cannot support. My review is calibrated to the specific case rather than to a generic approach, and my role is to identify what the medicine supports — and to say plainly where it does not.
Scope
Brain injury covers a wider clinical range than any single mechanism, and the analytical work differs meaningfully across the severity spectrum and across traumatic versus non-traumatic etiology. Cases I review typically fall within the following categories.
- Traumatic brain injury — across the severity spectrum — concussion and mild TBI, moderate TBI with imaging findings, severe TBI with prolonged impairment, and the post-concussive symptom persistence that defines much of the litigated mild-TBI space. Emphasis on distinguishing documented neurological impairment from non-neurological or preexisting symptom presentations.
- Hypoxic-ischemic brain injury — after cardiac arrest, respiratory failure, or perioperative and procedural events. Because the clinical framework for HIBI centers on post-arrest care and neuroprognostication, these cases are typically reviewed under Neurocritical Care; they are listed here because the mechanism is a brain injury.
- Causation and impairment analysis — under the AMA Guides to the Evaluation of Permanent Impairment (5th and 6th editions), when the case requires formal causation reasoning or an impairment rating distinct from the underlying clinical analysis.
I am a Certified ImPACT Consultant (CIC) with formal training in concussion assessment, and an ABIME-certified Independent Medical Examiner. Both credentials inform how I approach brain injury engagements; neither defines the scope of what I take on.
Engagement
Brain injury engagements span the spectrum of severity, and the form of engagement reflects where the case sits on it — from mild-TBI symptom-persistence questions to severe-injury impairment work.
- Pre-retention case consultation — a structured early conversation before formal engagement.
- Records review with written analysis — structured review and written analytical summary.
- Independent medical examination (IME) — in-person or video examination, conducted under ABIME standards, with a structured written report.
- Expert report — formal written expert report suitable for disclosure.
- Deposition and trial testimony — testimony consistent with the written record.
I review for plaintiff and defense counsel on an independent basis. I decline cases outside my clinical domain, cases where the record will not support the opinion sought, and cases where my schedule will not permit the attention the work requires.
Related Writings
Writings on brain injury, for counsel wanting to see how I reason about these cases before engaging.
- Traumatic Brain Injury in Litigation: Mechanism, Symptom, and the Causation Gap — Commentary on why most TBI litigation is fought in the mild range, and where the causation analysis tends to fray.
- Hypoxic-Ischemic Brain Injury: When the Fight Is About Timing — Commentary on HIBI causation, post-arrest care, and neuroprognostication.
- Neuroimaging in Litigation: What It Shows, What It Does Not Prove — Primer on the limits of CT, MRI, DTI, and fMRI as evidence in brain injury cases.