Louisiana Brain Injury Lawyers

TBI Classification and the Glasgow Coma Scale

Louisiana courts, insurers, and medical experts classify traumatic brain injury as mild, moderate, or severe using the GCS The score recorded by EMS at the scene and by the emergency department on admission is primary causation evidence in your case.

Mild TBI, commonly called concussion, often produces no visible abnormality on a standard CT scan. That does not mean the injury is insignificant. Symptoms including headache, cognitive fog, memory gaps, and irritability are real, documented, and compensable. Insurance adjusters routinely use a normal CT result to argue the injury did not happen. That argument is factually wrong and can be defeated with proper evidence.

Moderate TBI involves loss of consciousness from 30 minutes to 24 hours. CT or MRI findings are more likely at this severity level. The risk of post-traumatic epilepsy rises substantially. Severe TBI, defined by a GCS score of 3-8, typically involves DAI, extended unconsciousness, and permanent cognitive or physical impairment.

Two additional injury categories are worth understanding. Penetrating TBI, or open-head injury, occurs when an object enters the skull and brain tissue. This can result from high-speed collisions where vehicle components intrude into the passenger compartment, gunshots, or industrial projectiles. Non-traumatic acquired brain injury results from internal causes such as stroke, oxygen deprivation (anoxia), or infection. When a non-traumatic brain injury results from a medical provider's failure to act, a medical malpractice framework applies.

Ask any attorney you consult: what GCS score was documented at the scene, and how do they use that in establishing causation? An attorney who does not know the answer has not handled many TBI cases. Morris & Dewett handles the full range of Louisiana catastrophic injury cases, including all TBI severity levels.

Does a Normal CT Scan Rule Out a Brain Injury?

No. CT scans are fast and available at every Level I and Level II trauma center in Louisiana. They reliably detect acute bleeds, skull fractures, and large contusions. They do not detect axonal damage, which is the mechanism behind many of the most debilitating TBI symptoms.

Standard MRI improves on CT for soft tissue resolution. But even a conventional MRI misses diffuse axonal injury in many mild-to-moderate cases. The structures being damaged are the white matter tracts, which require specialized protocols to visualize.

Two advanced imaging protocols change this calculus. DTI identifies axonal shearing not visible on standard imaging. SWI identifies microhemorrhages from axonal tearing. Both protocols are increasingly accepted in Louisiana courts as substantive evidence of injury.

Insurance companies will cite the absence of findings on a standard CT as grounds to deny or minimize a TBI claim. This is a predictable tactic. DTI and SWI findings provide specific, documentable evidence that defeats it. The question is whether those studies were ordered, and whether the attorney handling your case knows to request them.

Ask any attorney you consult: do they work with a neuroradiologist who reads DTI and SWI studies, and have they used advanced imaging evidence in a Louisiana TBI case before?

Why TBI Symptoms Are Often Delayed

TBI symptoms do not always appear at the moment of impact. Brain inflammation, neurochemical disruption, and white matter tract injury produce symptoms that develop over hours, days, and sometimes weeks after the accident. This is documented in medical literature. It is not unusual. But it creates a predictable litigation problem.

Post-Concussion Syndrome involves symptoms that continue long after the initial injury. The absence of immediate emergency room findings does not rule it out.

Insurance companies and defense attorneys treat the gap between the accident and symptom onset as an opportunity. The argument is that symptoms appearing days or weeks later must be pre-existing or caused by something else. This argument has no medical basis. It is a litigation tactic, not a clinical conclusion.

The counter is documentation. Every symptom must be reported to a treating physician as it appears, and the physician's notes must connect the symptoms to the injury mechanism. Gaps in medical treatment are gaps in your case. The 2024 elimination of the Housley presumption in Louisiana means you can no longer rely on the court to presume causation. You must affirmatively document it through your own medical record.

Ask any attorney you consult: how do they advise clients whose symptoms did not appear until days or weeks after the accident? An attorney who handles TBI cases knows to guide clients through the documentation process from day one, not just at the point of formal diagnosis.

Cognitive Deficits and Behavioral Changes After TBI

Traumatic brain injury produces cognitive and behavioral consequences that are often more disruptive to daily life than the physical injuries and harder to document without specialized testing.

Post-TBI cognitive deficits include memory impairment, slowed processing speed, and executive function loss covering planning, sequencing, and impulse control. These affect job performance, relationships, and the ability to manage daily tasks. Personality changes, including impulsivity, emotional dysregulation, depression, and aggression, are direct neurological consequences of brain injury. They are not character flaws. They are documented sequelae with established neurological mechanisms.

Post-Traumatic Epilepsy represents a separate long-term consequence that adds ongoing medical costs and functional limitations to the damages calculation.

These injuries are called "invisible" because they do not appear on imaging that non-specialist reviewers consider routine. Defense IME doctors routinely dismiss cognitive and behavioral TBI sequelae as exaggerated or unrelated. Neuropsychological testing is the primary documentary counter to this tactic.

Neuropsychological Testing as Evidence

A neuropsychologist is not a psychiatrist. A neuropsychologist is a licensed psychologist with specialized doctoral-level training in brain-behavior relationships. They do not prescribe medications. They administer and interpret standardized test batteries that quantify how brain function has changed.

The standard test batteries used in TBI litigation include the WAIS-IV (intellectual function and processing speed), WMS-IV (memory across multiple modalities), Trail Making Test A and B (processing speed and cognitive flexibility), and the Delis-Kaplan Executive Function System (planning, sequencing, inhibition, and problem solving). Each test has population norms and statistical thresholds. The results are not subjective. They are numbers.

The neuropsychologist compares your test results against population norms and against your estimated pre-injury intellectual functioning. The deficit documented is specific, quantified, and tied to a particular cognitive domain. The report states whether those deficits are consistent with the known injury mechanism. This is the document that turns "she seems fine" into a measurable, compensable impairment.

Defense neuropsychologists challenge test validity using PVTs. An experienced plaintiff's neuropsychologist addresses this directly in their report by documenting consistency indicators across the entire battery.

Expert witness qualifications matter in Louisiana courts. The neuropsychologist must be board-certified by the American Board of Clinical Neuropsychology (ABCN) and must have prior testifying experience in Louisiana state or federal court. Ask any attorney you consult: who are the neuropsychologists they use, what is their board certification status, and how many times have they testified in Louisiana?

Long-Term Care Needs and Life Care Planning

The full economic cost of a severe TBI case is not known at the time of the accident. It is not known at the time of the initial settlement offer. It becomes known through a structured process of medical evaluation, vocational analysis, and financial projection.

Severe TBI survivors typically require a coordinated team of providers over their lifetime: neuropsychology follow-up, occupational therapy to rebuild daily living skills, speech-language pathology for cognitive-communication deficits, and physical therapy for motor impairment. Home modifications, assistive technology, and personal care attendants add to the long-term picture.

A certified life care planner (CLCP) builds the formal documentation of future medical needs. The life care plan is a line-item document specifying each type of care, frequency, cost, and duration over the survivor's projected lifetime. It is prepared by a credentialed specialist, not estimated by the attorney. This document is required to support a full future damages claim.

Lost earning capacity is calculated separately. A vocational rehabilitation expert assesses the difference between pre-injury work capacity and post-injury work capacity. An economist converts that difference to present value using actuarial methods. Together, these form the economic damages foundation of a severe TBI case.

Louisiana's Traumatic Brain and Spinal Cord Injury Trust Fund Program, managed through the Louisiana Department of Health, provides ongoing services to qualifying Louisiana TBI survivors. This program is a resource for long-term care coordination independent of litigation outcomes.

Insurance companies make early settlement offers before life care planning is complete. Accepting an early offer closes all future claims. Once you settle, you cannot return for additional compensation if the true extent of long-term care needs becomes clear later.

How Insurance Companies Minimize TBI Claims

TBI cases produce predictable defense tactics. Understanding them in advance reduces their effectiveness.

Early recorded statements are the most damaging. An insurance adjuster contacts the injured person within days of the accident and asks open-ended questions about symptoms. TBI symptoms often have not fully manifested yet. The injured person says they feel "okay" or "not that bad." That statement is recorded. It is later used to contradict claims of ongoing cognitive impairment. The standard practice at Morris & Dewett is to require all communications to go through counsel once we are retained. We do not allow adjusters direct access to our clients on catastrophic cases.

IME doctors are selected and paid by the insurance company. A single examination lasting 30-60 minutes is the basis for a report that frequently concludes TBI symptoms are exaggerated, pre-existing, or unrelated to the accident. These reports are predictable in their conclusions. They are contestable through the treating physician's longitudinal records, neuropsychological testing, and advanced imaging.

Timeline attacks argue that symptoms appearing weeks or months after the accident are not related to it. Thorough treating physician records that document the progression of symptoms from injury date forward defeat this argument. The 2024 elimination of Louisiana's Housley presumption makes continuous medical documentation more critical than it was before.

Louisiana's Direct Action Statute (La. R.S. 22:1269) allows direct suits against insurers, which matters for enforcement and collection when the at-fault party has limited personal assets.

Louisiana Law and TBI Claims: What Changed in 2024 and 2026

Louisiana's personal injury law changed substantially in 2024 and 2026. These changes affect every TBI case filed in the state.

The 2024 tort reform package eliminated the Housley v. Cerise presumption. Under the old rule, a plaintiff who was healthy before an accident and developed symptoms after it benefited from a presumption that the accident caused the symptoms. The defense had to overcome that presumption. Under La. R.S. 9:2800.27 (effective July 1, 2024), that presumption is gone. You must prove causation affirmatively. This shifts the burden and makes thorough medical documentation and expert testimony more important, not less.

The 2026 amendment to La. R.S. 9:2800.27 limits recoverable medical expenses to amounts actually paid by health insurers, Medicare, or Medicaid. Billed amounts in excess of what was actually paid are no longer recoverable except for out-of-pocket costs. TBI medical bills are often substantial. This change requires careful analysis of what was billed versus what was paid when calculating economic damages.

Comparative Fault under La. C.C. Art. 2323 (effective January 1, 2026) applies the 51% bar. Insurance defense strategies routinely include efforts to push fault attribution to or past 51%. In TBI cases where the accident mechanism is disputed, comparative fault analysis requires accident reconstruction evidence.

The Prescriptive Period for personal injury in Louisiana is two years from the date of injury under La. C.C. Art. 3493.11 (effective July 1, 2024). Discovery of a TBI diagnosis may not always happen at the moment of accident. In cases where the injury is discovered later, the discovery rule may toll the period. This requires legal analysis specific to the circumstances.

The Evidence Timeline: What Must Be Preserved

Evidence in a TBI case has a natural decay rate. Some of it is gone within 30-72 hours of the accident. Building a complete evidence record is time-sensitive.

First responder and EMS records document the GCS score at the scene, the initial neurological assessment, and transport decisions. These are often among the most important documents in the case because they establish baseline neurological status at the moment closest to the injury. Emergency department records, CT and MRI imaging, and radiology reports document the initial clinical picture.

Surveillance footage from traffic cameras, commercial properties, and dashcams typically loops and overwrites within 30 to 72 hours. Employment records establish pre-injury work capacity and salary history. These form the baseline for the earning capacity calculation.

Louisiana has no automatic evidence preservation requirement. A formal Preservation Letter must be sent to the at-fault party promptly. Without it, the at-fault party and their insurer are under no obligation to retain vehicle data, surveillance footage, or communications records.

Accident reconstruction reports become important in cases where the crash mechanics are disputed. The forces involved in the collision directly relate to the biomechanical plausibility of the claimed injury. This is especially relevant in mild TBI cases where the defense argues the collision was too minor to cause brain injury.

Neuropsychological evaluations completed after sufficient time post-injury, typically at three to six months, document the stabilized cognitive picture. Employment and academic records from before the injury establish the pre-injury baseline for comparison.

The practical implication is that the attorney needs to be involved early. The window for preserving time-sensitive evidence closes quickly.

Ask any attorney you consult: what do they do in the first 72 hours after being retained on a TBI case? The answer should include sending preservation demands, identifying surveillance footage sources, and securing EMS and dispatch records before they are overwritten.

How to Evaluate a Brain Injury Attorney in Louisiana

Not every personal injury attorney has handled TBI cases. The technical demands are different. The expert network is different. The litigation strategy is different.

Ask any attorney you consult these specific questions. Who are the neuropsychologists they use, and are those neuropsychologists board-certified by ABCN? Do they have a neuroradiologist who reads DTI and SWI studies? Have they retained life care planners and vocational economists in prior cases, and are those experts familiar with Louisiana wage and medical cost data? Have they taken a TBI case to verdict in Louisiana, or do they settle everything before trial?

The answers to those questions tell you whether the attorney has built the infrastructure a serious TBI case requires or whether they are learning it on yours.

Morris & Dewett has handled catastrophic injury cases across Louisiana for over 25 years. Our attorneys hold AV Preeminent ratings from Martindale-Hubbell and have been recognized by Super Lawyers. We work with board-certified neuropsychologists, neuroradiologists who read advanced imaging studies, and life care planners with Louisiana-specific cost data. We have taken cases to verdict.

Morris & Dewett operates on a contingency fee basis. You pay no attorney fees unless there is a recovery.

Frequently Asked Questions

How long do I have to file a brain injury lawsuit in Louisiana?

Two years from the date of injury under [La. C.C. Art. 3493.11](https://legis.la.gov/legis/Law.aspx?d=109391), effective July 1, 2024. If the brain injury was not immediately diagnosable, the discovery rule may extend this period from the date the injury was reasonably discovered. Missing the deadline permanently bars the claim. An attorney should evaluate the specific facts to determine the controlling date.

What is the Glasgow Coma Scale and why does it matter in my case?

The Glasgow Coma Scale (GCS) is a 15-point neurological scoring system measuring eye opening, verbal response, and motor response. First responders and emergency departments document the score at scene and admission. It classifies TBI severity as mild (13-15), moderate (9-12), or severe (3-8). In litigation, the GCS score is primary evidence establishing the severity of the brain injury at the moment of the accident, before any treatment or recovery.

Can I still recover damages if my CT scan came back normal?

Yes. A normal CT scan does not rule out TBI. CT scans detect acute bleeds and fractures but miss diffuse axonal injury and many forms of white matter damage. Standard MRI also misses axonal shearing in many cases. Advanced imaging protocols, specifically diffusion tensor imaging (DTI) and susceptibility-weighted imaging (SWI), can detect injury that CT and standard MRI miss. Neuropsychological testing documents cognitive deficits independent of imaging findings.

What does a neuropsychologist do in a TBI case?

A neuropsychologist administers standardized test batteries that measure cognitive function across multiple domains: intellectual processing, memory, processing speed, and executive function. The results are compared against population norms and the patient's estimated pre-injury baseline to document specific deficits. The neuropsychologist's report identifies which cognitive domains are impaired, by how much, and whether the pattern is consistent with the known injury mechanism. This documentation is admissible evidence of cognitive TBI sequelae in Louisiana courts.

What is diffuse axonal injury and is it detectable?

Diffuse axonal injury (DAI) is widespread tearing of the brain's white matter axons caused by rotational forces from high-speed impacts or sudden deceleration. It is the mechanism behind many cases of persistent vegetative state and severe long-term disability after TBI. Standard CT scans regularly miss DAI. Diffusion tensor imaging (DTI) maps white matter tract integrity and can detect axonal shearing. Susceptibility-weighted imaging (SWI) identifies microhemorrhages from the same mechanism. Both protocols are increasingly accepted in Louisiana litigation.

How does post-traumatic epilepsy affect a TBI claim?

Post-traumatic epilepsy (PTE) is a seizure disorder that develops after TBI, typically in 5-20% of moderate-to-severe cases. Onset can occur weeks to months after the initial injury. PTE requires long-term anticonvulsant medication management, affects driving privileges under Louisiana law, and restricts many forms of employment. It represents a separate ongoing medical condition with its own future treatment costs. A life care plan must account for PTE management costs separately from the primary TBI treatment plan.

What are the first steps I should take after a traumatic brain injury?

Seek emergency medical evaluation immediately, even if symptoms seem minor at first. Report all symptoms to the treating physician at every visit, including symptoms that develop in the days and weeks after the accident. Follow all medical recommendations and do not miss appointments. Do not provide recorded statements to any insurance adjuster before consulting an attorney. Contact an attorney as early as possible to preserve time-sensitive evidence before surveillance footage is overwritten and other records are lost.

How does the 2024 tort reform affect my TBI case?

The 2024 Louisiana tort reform, under [La. R.S. 9:2800.27](https://legis.la.gov/legis/Law.aspx?d=1243781) (effective July 1, 2024), eliminated the Housley v. Cerise presumption. Previously, a plaintiff who was healthy before an accident and developed symptoms after it benefited from a legal presumption that the accident caused those symptoms. That presumption is gone. You now must prove causation affirmatively through medical records, expert testimony, and imaging. Continuous treating physician documentation and neuropsychological testing are more important under the new standard than they were before.

Can I sue if my brain injury symptoms only appeared weeks after the accident?

Yes. Delayed symptom onset is medically documented and legally recognized in Louisiana. Brain inflammation and neurochemical disruption produce symptoms over time, not all at once. The key is continuous medical documentation starting at the time of the accident, with each new symptom recorded and connected to the injury mechanism by the treating physician. Insurance companies argue that delayed symptoms are unrelated to the accident. A documented medical record from injury date forward defeats that argument.

How does Louisiana's 2026 law limit my medical expense recovery in a TBI case?

The 2026 amendment to La. R.S. 9:2800.27 limits recoverable medical expenses to the amounts actually paid by health insurers, Medicare, or Medicaid, not the amounts billed. The difference between billed charges and paid amounts can be substantial in TBI cases involving hospitalization and specialized care. Out-of-pocket expenses not covered by insurance remain fully recoverable. This change requires careful analysis of what was actually paid versus billed when calculating your economic damages.

What is an independent medical examination and can I refuse it?

An independent medical examination (IME) is a medical evaluation requested by the opposing party or their insurer, conducted by a physician of their choosing. In Louisiana personal injury litigation, a defendant may request an IME under [La. C.C.P. Art. 1464](https://legis.la.gov/legis/Law.aspx?d=111222). You generally cannot refuse it once litigation has commenced. However, your attorney can request the same type of examination, propose a different examiner, and limit the scope. The IME doctor's conclusions should be countered by your treating physician's longitudinal records and your independent neuropsychological evaluation.

How do I prove negligence in a brain injury case in Louisiana?

To prove negligence in Louisiana, you establish four elements under [La. C.C. Art. 2315](https://legis.la.gov/legis/Law.aspx?d=109147): duty (the defendant owed a duty to act reasonably), breach (they failed to meet that duty), causation (the breach caused your injury), and damages (you suffered compensable harm). In TBI cases, causation is typically the most contested element, especially after the 2024 elimination of the Housley presumption. Medical records, expert testimony, advanced imaging, and neuropsychological testing together establish that the accident caused the documented brain injury.

These answers reflect Louisiana law as of January 2026. For case specific advice, consult with a Louisiana personal injury attorney who can evaluate your particular circumstances.