Brain Injury Guide

Introduction to brain injuries

1. What is a brain injury?
2. Types of brain injury
3. Measuring the severity of a brain injury
4. Why choose Lime Solicitors?
5. Brain injury treatment and rehabilitation
6. How brain injuries can affect people differently?
7. Making a brain injury claim
8. Court of Protection and Trusts
9. Client stories

What is a brain injury?

A brain injury is any type of harmful impact to the functioning of the brain. This can happen in several different scenarios. A person might suffer a brain injury due to a personal injury such as a road traffic accident, a fall or sports injury, or by illness or even through medical negligence.

Types of brain injury

An acquired brain injury is any brain injury that has occurred after birth. Acquired brain injuries fall into 2 categories, traumatic brain injury and non-traumatic brain injury.

Traumatic brain injury

A traumatic brain injury (TBI) is an alteration in brain function that is caused by an external force. Not all head injuries will result in a traumatic brain injury. Traumatic brain injury types can be categorised into penetrating TBIs and non-penetrating TBIs. A penetrating TBI refers to when an object pierces the skull and enters the brain tissue, whereas a non-penetrating TBI is where blunt force to the head has caused the brain to move without the skull being pierced. This may also include diffuse brain injuries, where the head is shaken and causes damage to the brain, or brain contusion where the brain may be bruised or swollen due to fractures in the skull. There are usually clear symptoms of a TBI, including but not limited to:

Headaches and blurred vision;

Clear fluid in the nose or ears;

Slurred speech;

Limb weakness;

Confusion and/or disorientation;

Seizures and/or convulsions;

Memory loss and decreased levels of consciousness.

Non-traumatic brain injury

Simply put, a non-traumatic brain injury is an injury to the brain cause by internal factors. These can happen before birth, during birth and throughout a person’s life. Examples of non-traumatic brain injuries can include injuries caused by infection, strokes, aneurysms or tumours.

Birth injury causing brain injury

One example of non-traumatic brain injury can be injuries sustained during birth trauma, such as hypoxic brain injuries, which can occur in babies if they don’t receive enough oxygen. We work closely with our specialist medical negligence team, who handle childbirth brain injury cases of this nature.

Measuring the severity of a brain injury

The Glasgow Coma Scale (GCS score) is a tool used to classify the severity of a brain injury. This involves assessing the following:

A patient’s verbal responses;

A patient’s motor responses;

A patient’s visual responses.

In children under 36 months of age, the Paediatric Glasgow Coma Scale will be used instead. A patient who has sustained a brain injury may also experience retrograde amnesia and/or post-traumatic amnesia. Both of these are significant markers in terms of measuring the severity of a brain injury.

Why choose Lime Solicitors to handle your brain injury claim?

Our team of serious injury solicitors have been helping people and families affected by brain injury for over 30 years. We help people and families get the brain injury compensation they deserve following a serious and traumatic injury. We travel across the UK to visit clients in their time of need, and make sure they have all the information they need to make the recovery journey and legal process easier. We understand the scale of the impact brain injury can have on a person, no matter age or gender, and make use of our highly skilled resource and strong connections in the medical space to give every brain injured client a chance at recovery and getting their life back on track.

Supporting your loved ones following a brain injury

We know the impact a brain injury can have on an individual. But that’s not the extent of the impact – a loved one and close family may also be affected. If your partner, parent, child or close friend sustains a brain injury it can be difficult for you to navigate as well as them – particularly with how to interact with them during their recovery and beyond. We work with many organisations that specialise in help and support for people who are affected when their loved one sustains a brain injury. We’d be happy to have a chat with you and talk through your situation. Another concern people have is the financial impact of a brain injury. If a sole earner of a household sustains this type of injury and is no longer able to work, what happens next? We understand the panic during an already stressful time and will do what we can to secure interim payments so that loved ones and dependents aren’t left with nothing. We discuss this more in the next section below.

Brain injury treatment and rehabilitation

Treatment and rehabilitation are not the same for everyone. Depending on the scale of a brain injury, and other factors such as loss of earnings, life circumstances and the nature of the incident where the injury happened, treatment and rehabilitation may differ. During your traumatic brain injury claim, we’ll keep you and your loved ones up to date on what’s being recommended. We can help to provide the ongoing support and guidance you or your loved one needs following a brain injury, with a care plan tailored to your unique circumstances. In our experience this collaborative approach enables the best chances of recovery.

What is rehabilitation like?

Rehabilitation is something we believe is fundamental to helping people get their lives back following a serious brain injury. We’ve worked with many people and families to secure them the rehabilitation they need, based on their unique circumstances. Rehabilitation involves several key elements, including:

Physiotherapy to help regain and strengthen motor skills;

Psychotherapy to help recover mentally from injury;

Respiratory therapy;

Speech therapy;

Occupational therapy to aid cognitive healing;

Counselling for couples and families affected;

Supportive equipment and home adaptations to aid recovery.

We work with expert organisations to ensure every client who needs it is given a bespoke rehabilitation package, tailored according to their needs. You can find out more about the rehabilitation work we do here.

How brain injuries can affect people differently

The consequences of a brain injury can be severe for anyone. The classification of the severity of the initial brain injury is not necessarily determinative as to the severity of the ongoing symptoms following brain injury. Brain injury will affect every person differently, and how it impacts upon people can depend on many factors, including which part of the brain has been damaged and the age of the injured person.

Brain injury in young children

When a child sustains a brain injury it may have a lasting, lifelong impact. Brain injuries in children can develop differently to those in adults as they occur at a time when the brain is still developing. Brain injury in children may cause future problems with attention span, difficulty with concentration and navigating social situations, or even a short temper. However, a child’s brain may develop new or alternative ways to process information In most child brain injury cases, the extent of any lasting damage may not be fully known until the age of around 25. It is imperative that children that have sustained traumatic brain injury receive appropriate specialist support.

Brain injury in older children and teenagers

A child may find going through teenage years and puberty a challenge in itself, and this can be exacerbated by a brain injury. It requires specialist input to extrapolate what issues may arise as a consequence of brain injury as opposed to being normal pubescent behaviour and to provide the holistic support required.

Brain injury in elderly people

The impact of a brain injury on elderly people can be challenging, as it can make any pre-existing issues worse. The effects may seem magnified due to brain shrinkage (normal in old age) and an injury to the brain may also heighten the risks of dementia.

Making a brain injury claim

We understand how daunting the legal process can be, especially for a family who have recently been affected by a serious brain injury. The last thing we want is for anyone to feel unable to seek the help they or their loved one needs. In the first instance, we encourage you to contact our team. We’re understanding, friendly and our sole aim is to make sure your claim is handled by a brain injury expert, who can give you the right information and guidance to help. If you choose us to handle your brain injury claim, we’ll set up a meeting with you and your loved one, where we will explain the legal process to you and how we’ll support you every step of the way, from the beginning of your claim to beyond your recovery journey. In these meetings we’ll touch on the technicalities of the brain injury claim process, including how we gather evidence, how yours or your loved one’s injury will be assessed, and other important details to help you feel at ease. Our team is totally flexible and will meet you at a place that is most convenient for you and your loved ones. Whether we meet you in hospital or in your own home, we’ll travel to you to ease the burden and are happy to adapt throughout your journey depending on what works best for you. Our priority is making sure anyone who asks us to help them with their brain injury claim is given full support throughout the legal process. This not only includes the patient themselves – it also includes friends and family members who are part of the support system. Traumatic brain injuries affect people and those closest to them, and we understand the emotional impact this can have.

Severe traumatic brain injury recovery time

Recovery looks different for every individual following a brain injury. Some people may take weeks whereas others can take months or years. Often a patient sustaining a traumatic brain injury may remain unconscious for a certain period due to the swelling of the brain. As the swelling starts to go down, a person may start to regain consciousness.

Hypoxic brain injury recovery time

Hypoxic brain injury recovery will of course depend on the severity of the injury. The quickest recovery is usually within the first six months following the injury, with long-term outcomes being easier to identify towards the 12-month mark. Depending on yours or your loved one’s circumstances, we’ll be able to get you the help and support needed to ensure the best possible recovery journey.

Court of Protection and Trusts

What is the Court of Protection?

The Court of Protection was made under the Mental Health Act 2005 and was created to help support people who lack the mental capacity to make financial or welfare decisions on their own.

Why might you need to involve the Court of Protection?

A serious brain injury can impact a person’s ability to make decisions. The Court of Protection will/would have appointed a deputy to handle health and personal welfare decisions and financial decisions, although in some cases a different deputy may be appointed for that. As mentioned above, financial decisions that may have normally been made by the brain-injured person will need to be handled in an alternative manner in the immediate aftermath of a brain injury. But this doesn’t just apply to financial decisions – it also applies to treatment decisions. Medical professionals are responsible for making immediate treatment decisions, unless the patient has a legally appointed representative (deputy) available to make the decisions instead. When a person lacks mental capacity, every decision made on their behalf regarding their wellbeing should be made with their best interests at heart. Medical professionals should conduct appropriate discussions with family members and/or representatives following a patient’s brain injury, to make sure any agreements are reached. An assessment for mental capacity will always be conducted, depending on how a patient responds to immediate treatment administered by medical professionals.

Personal injury trusts

Setting up a personal injury trust may be a preferable idea following a brain injury, especially if your loved one no longer has capacity to manage their financial affairs. If you pursue a brain injury claim with us and you are awarded compensation, our team can help set up a personal injury trust where the money can be kept and managed properly. Keeping any compensation in a personal injury trust means the compensation amount is disregarded from means testing. It allows for your loved one to receive the money they deserve and the ongoing benefits they need, such as income support, housing benefit, jobseeker’s allowance or employment allowance following their brain injury. Keeping any compensation in a personal injury trust also allows for careful planning away from other finances. If your loved one lacks capacity due to their brain injury, the trustees would be able to make sure the compensation covers all the things it needs to, such as further medical treatment or rehabilitation. These trusts can also be set up for children if they are awarded compensation for brain injury. The trust would be accessed by a parent until the child’s 18th birthday.

Call us free today on 0808 164 0808, or request a call back if you’d like one of our experts to call you.

Client Stories

Hear Verity's Story

We acted on behalf of Verity, a child who was 20 months old when she was trapped underneath a reversing car, which was being driven by her father while on a family camping holiday. The case is the most tragic that anyone involved in Verity’s care and treatment had ever come across and was an emotionally very complex case.

As a result of what we believe to be the largest annual interim payment on record (£600,000), we were able to implement a privately-funded rehabilitation package for Verity. A large multi-disciplinary team was established connecting statutory services with private services to ensure clinical input was goal-focused and achieved the best outcomes for Verity.

The case was complex in terms of the support Verity’s family required given the tragic circumstances of the accident. The emotionally complexities of the case impacted Verity’s care team, who received psychological support.

Verity’s life expectancy was a significant area of dispute between the parties and there were real challenges in ensuring a consistent 2:1 care package, which included an employed full-time nurse. Despite the expert evidence not supporting a care package that directly employed a nurse beyond the settlement, we successfully argued for one as part of the overall settlement.

As part of the settlement negotiations, Verity’s family wanted to ensure the involvement of the Clinical Commissioning Group in terms of the continuity of training it provides to the care team. Whilst unusual in a case of this nature, the family were keen to ensure this continued as it was working well in practice and provided a linchpin between statutory support and the private rehab package. A number of options were explored – a Peters undertaking, a reverse indemnity and withdrawing Verity from statutory funded support.

The case settled for approximately £20 million, which included a periodical payments order (PPO) of £600,000 per annum. We have been advised that this is within the top five PPOs on record. The settlement was approved by The Honourable Mr Justice Ritchie.

The court also approved a reverse indemnity that terminates upon Verity’s life expectancy (negotiated: aged 25) to ensure continuation of care. We believe this is the first of its kind. Reverse indemnities are extremely uncommon as they are incredibly complex both in terms of drafting and practical application. However, we fought for this to ensure Verity’s family does not end up ”topping up” funding for the 24-hour care package if their child outlives the expert evidence’s predicted life expectancy.

Negotiations took place over five weeks and the reverse indemnity was agreed, subject to court approval, due to a continued collaborative approach with the defendant.

Hear John's Story

Our client could not return to his previous role at work following his injuries. We succeeded in an agreement to fund his rehabilitation under the Rehabilitation Code.

We acted for John, a gentleman who suffered a severe traumatic brain injury following a road traffic incident, resulting in significant cognitive decline and a diagnosis of Organic Personality Disorder. Other injuries included a spinal fracture, vestibular dysfunction, deafness in one ear, and a fractured leg.

John made an excellent recovery with the support of privately funded rehabilitation under the Rehabilitation Code but was unable to return to his senior executive role held at the time of the incident due to personality changes and a decline in his memory.

The primary issues between the parties concerned John’s likely career trajectory in the absence of the incident, and the diagnosis of Organic Personality Disorder. Considerable efforts were made to obtain supportive witness evidence from former colleagues to prove the career trajectory.

Expert evidence was obtained by both parties from forensic accounts and employment consultants to help narrow the issues and to enable a negotiated settlement for John. His personal injury claim settled for £3.5m following a joint settlement meeting several months before a 10-day trial, listed at the Royal Court of Justice.

Martin Usher

Head of Serious Injury

Martin joined Lime Solicitors as a partner in May 2021, and has over 15 years’ experience in dealing with serious injury and major trauma cases including traumatic brain injuries, spinal cord injuries, complex musculoskeletal injuries and amputations.

Martin is a committee member for the Major Trauma Group, a not-for-profit community interest company, to assist major trauma victims. The philosophy of the group aligns with Martin’s views that the focus should be on ensuring that all required support and guidance is provided throughout the injured person’s journey.

Martin served over six years as a Trustee for Headway Southampton, including three years as Chair. Martin has recently taken up a position as a Trustee at Headway South West London and is listed on the solicitor directory for Headway UK.

Martin is a vocal advocate for diversity and inclusion and was one of the founding members of his previous firm’s Women in Leadership in Law group. In this regard Martin is driven by a firm belief that there should be equality of opportunity for all.