Traumatic brain injury (TBI), concussion, and mild traumatic brain injury (MTBI) cases frequently present complex and disputed functional issues that extend well beyond what is visible on imaging or reflected in isolated medical records. Individuals may appear outwardly intact while experiencing meaningful limitations in attention, endurance, executive functioning, emotional regulation, sensory tolerance, and daily performance.
In these cases, the accuracy and credibility of a life care plan depends on the evaluator’s ability to translate neurological injury into real-world functional impact and future care needs. A Certified Life Care Planner (CLCP) with direct brain injury experience is uniquely positioned to provide this level of analysis.
Brain injury cases differ from purely orthopedic or medical claims in that functional impairment is often variable, cumulative, and influenced by cognitive, sensory, emotional, and endurance-related factors. Concussion and mild traumatic brain injury may involve delayed onset of symptoms, fluctuating presentation, or prolonged recovery despite normal imaging.
A brain-injury–experienced CLCP evaluates not only diagnoses, but how neurological changes affect daily activities, work performance, safety, and long-term independence. This functional perspective is critical when future care needs, household services, vocational capacity, and supportive interventions are being evaluated for litigation purposes.
Specialized life care planning is particularly relevant in cases involving:
Brain injury exists along a spectrum, from concussion and MTBI to more complex moderate and severe injuries. While medical classifications are important, life care planning focuses on how the injury affects a person’s functional capacity over time.
Individuals with concussion or MTBI may experience slower cognitive processing, difficulty multitasking, reduced tolerance for sustained activity, visual discomfort, headaches, fatigue, or increased symptom exacerbation with prolonged work or screen use. For some, these symptoms persist and evolve into post-concussion syndrome, impacting reliability, pacing, and daily consistency.
Moderate to severe brain injuries may involve broader changes in memory, executive function, emotional regulation, communication, coordination, and safety awareness. These changes can affect driving, household management, employment, social participation, and independent living, all of which must be addressed in a defensible brain injury life care plan.
A CLCP with brain injury experience translates neurological findings into functional implications that are meaningful in a legal context. This includes analysis of:
By grounding recommendations in documented medical care and functional presentation, the life care plan provides a clear framework for understanding future needs while remaining consistent with accepted life care planning methodology.
A 35-year-old professional sustains a concussion in a high-speed rear-end collision and is diagnosed with mild traumatic brain injury (MTBI). Initial imaging is unremarkable. Despite conservative management, she develops persistent post-concussion symptoms affecting attention, cognitive endurance, visual tolerance, and fatigue.
Months later, treating providers document post-concussion syndrome with ongoing functional limitations impacting both work performance and daily activities.
Key legal and functional considerations include:
From a damages perspective, these limitations influence employability, household service needs, future medical management, and long-term support costs—elements that must be accurately reflected in a defensible life care plan.
Can significant impairment exist with normal imaging?
Yes. Functional limitations following concussion or MTBI are frequently present despite normal imaging findings and require clinical and functional assessment.
Why are mild TBI cases often disputed?
Because symptoms may be subtle, delayed, or variable, functional impact is sometimes underestimated without specialized evaluation.
How does cognitive fatigue affect long-term functioning?
Reduced endurance and symptom exacerbation over time can significantly limit work capacity, daily productivity, and consistency.
Dr. Ashea Neil, OTD, OTR/L, CLCP
Doctor of Occupational Therapy • Certified Life Care Planner • Certified Work Capacity Evaluator
Dr. Neil provides clinically grounded evaluation and expert support in orthopaedic, neurological, chronic pain, pediatric, and traumatic injury cases, including extensive experience in brain injury rehabilitation. For more than fifteen years, she has worked with individuals recovering from concussion, mild traumatic brain injury, and more complex brain injury presentations.
Her background includes specialized training in concussion and traumatic brain injury, advanced functional assessment coursework, vestibular rehabilitation experience, and direct involvement in rehabilitation programming for neurological populations. She has published and presented on concussion-related functional assessment and visual-vestibular impairment.
In her medical-legal practice, Dr. Neil provides life care planning, functional capacity evaluation, and vocational assessment services. Her opinions are grounded in functional performance analysis and presented in a clear, defensible manner appropriate for mediation, deposition, and trial.
If you are assessing a concussion or traumatic brain injury case and would like to discuss appropriate life care planning scope or functional considerations, our team is available to consult and assist in determining the appropriate level of analysis.
