Financial compensation and head injury

Abstract

‘Financial compensation’ and ‘head injury’ are two topics which have long been linked in the minds of health professionals, and there is no doubt that some suspicion may arise as to the genuineness of impairments in individuals who are known to be claiming compensation. It would, however, be unfortunate to fail to acknowledge two simple truths. Firstly, the great majority of those who have suffered frank brain injury do not exaggerate or invent symptoms. It has been shown that the frequency with which a variety of physical, cognitive, and emotionaVbehavioural sequelae are found and reported after head injury does not &ffer significantly between those cases in which a claim for financial compensation is being pursued and those in which it is not [l]. If there is a danger, it is that some of those with serious brain injury may make light of their symptoms so that unless a percipient health professional assesses them carefully, the extent of their disability may not be uncovered [2,3]. Secondly, significant brain injury carries major implications for the future of the injured person and his or her family. In cases where there has not been access to specialized rehabilitation, major features of the post head-injury picture are poor employment prospects and stress on caring relatives. As regards return to employment, in Brooks et al.’s [4] study of 134 cases between 2 and 7 years post-injury, the percentage in employment fell from 86% before injury to 29% after injury, and there was no improvement in the percentage employed between two and seven years post-injury. There is also significant stress on caring relatives, making them much more vulnerable, and in need of help, support, and respite: indeed Livingston et al. [5] have shown that the levels of stress are far from trivial, and are ofien of sufficient intensity that they would normally be considered to warrant psychiatric or psychological intervention. Moreover, it is clear that family members experience a range of problems [6] and that the levels of stress they experience do not decline, but indeed worsen with the passage of years [7]. Against this background, suitable financial compensation can provide the injured person with access to rehabilitation and care services to an extent that is often not otherwise possible. Such rehabilitation and care will often impact considerably (e.g. [S-111) on the major problems that would otherwise be present long-term. Furthermore, a proper financial settlement can mean that the brain-injured and their families need not suffer, in addition to the disabilities resulting from injury, the additional burdens of the extensive financial hardship which may also result from brain injury [12]. However, it is not the severely brain-injured who give rise to the greatest difficulties as