Does Timing Matter for TBI Testing in a PI Case?

Who this is for: Written for personal injury attorneys and case managers who are asking whether a client's testing is "too late" or "too early", and what timing actually depends on.

Timing is a clinical question first

The question usually arrives as a calendar question: is it too soon, or has too much time passed? The useful answer starts somewhere else. Testing is appropriate when a client's treating provider believes persistent symptoms warrant a standardized evaluation. That decision rests on the patient's history and symptoms, not on a demand deadline or a deposition date.

Testing arranged around legal milestones rather than patient care can work against everyone. It can delay care the client needs, and it invites the question of why the test was done when it was.

Timing should follow clinical need. Testing arranged around deadlines can undermine both the patient's care and the credibility of the record.

Why earlier evaluation can help the patient

When symptoms last beyond the first few weeks, an earlier standardized evaluation can help the treating provider plan care, adjust activities and involve specialists sooner. Clients who wait months often struggle at work and at home in the meantime.

There is a records point too. Notes written close to the time symptoms develop tend to be clearer than recollections pieced together later. That is a reason to encourage prompt care and complete symptom reporting, not a reason to rush testing.

Later testing still has a place

Persistent symptoms can be evaluated at any point. A client who first mentions memory trouble or dizziness months after a crash is not too late to be evaluated, if the treating provider decides an evaluation is warranted. The earlier visit notes still matter, because they show when symptoms were first described.

Related in this series: How Attorneys Can Prepare Clients for Concussion Testing, Head Injury Documentation Attorneys Review Before a Demand and Standardized vs. Subjective Findings in Concussion Cases. For the full overview, start with our guide, Attorney Guide to TBI Documentation.

Every result is a snapshot

Functional test results describe how a person performed on the test date. Symptoms may improve, plateau or change. Sometimes a treating provider decides follow-up testing would help show how function has changed. That decision belongs to the provider, based on clinical judgment.

A test result describes how a person performed on one day. The provider decides whether a later comparison would help.

What attorneys can do, and what to leave alone

• Ask about head-injury symptoms early, at intake, and again at follow-up calls.
• Encourage clients to get care promptly and to tell their providers about every symptom.
• Make sure each client has a treating provider who can decide whether testing is warranted.
• Request records through authorized channels.
• Leave clinical decisions, including when to test, to the provider.

A realistic sequence

A client is rear-ended and sees a chiropractor for neck pain. At the four-week re-exam she mentions brain fog, and the chiropractor documents it. At six weeks there is no improvement, so the chiropractor refers for testing. The report goes into the chart, and the provider arranges a vestibular evaluation. The attorney later receives the records through the usual authorized process. Clinical need drove each step, which is what makes the record coherent.

Related reading:
How mobile testing works Concussion & TBI testing Attorneys Service areas preparing client for concussion testing sleep changes after concussion