When Should an Attorney Refer to an Expert Forensic Neuropsychologist?
While you may wish to avoid coaching your clients, it can be helpful to identify when referral to an expert forensic neuropsychologist is warranted within the context of a personal injury case. Here are several guidelines in the case of possible concussion or traumatic brain injury (TBI):
1) ASK: Do you believe that you experienced a powerful force or blow to your head? Ask this in question form rather than informing the client that you think this is the case.
2) ASK: Have you noticed any changes in your thinking skills that YOU my client believe are due to the accident? Are you currently experiencing any of the following problems that YOU my client think might be related to a possible head injury or concussion? It is not uncommon for people to experience these symptoms at other points in life; have you also experienced these symptoms before the accident? (check all that apply, but avoid suggesting or “leading” the client to believe as such):
A. Headaches or vomiting
B. Ringing in the ears
D. Irritability or other mood changes
E. Memory problems
F. Sleep problems
G. Balance problems
H. Other specify (e.g., double vision):_____________________
As an attorney:
_______ Refer anyone to an expert forensic neuropsychologist who experienced a powerful force or blow to the head AND who believes they are experiencing any current memory, attentional, and/or mood changes post-accident which may or may not be due to the accident but which the client reports experiencing since the accident.
_______ For military populations, blast exposure within 50 meters of a blast should trigger referral if the service member feels s/he has current issues due to TBI.
_______ Best practice is to refrain from “leading” questions. You can explain that memory, attention, and mood changes have many causes, and that the expert forensic neuropsychologist will identify the source of current issues. You can also explain that the initial cause of memory (or other) changes may or may not be what maintains these changes or keeps them going to the present day at this point. Other factors such as sleep problems and stress can be what keeps the changes going.
_______ Can tell your client that the expert forensic neuropsychologist will determine whether or not their injury meets criteria for a TBI, and will try to determine the source of their current cognitive (or mood, if applicable) changes. The forensic neuropsychologist may do some testing to determine their cognitive strengths and weaknesses.
About the author. Dr. Messler is a board certified clinical neuropsychologist and licensed psychologist who has provided thousands of evaluations where the question of traumatic brain injury was raised. She has also served as expert consultant and witness. She believes it is critical to provide an objective, scientifically defensible opinion, and to help the jury and court understand the implications of the neuropsychological aspects of cases before them.