Winning The TBI Case

Tom Crosley
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“Winning the TBI Case” with Tom Crosley is a podcast created exclusively for plaintiff attorneys handling traumatic brain injury (TBI) cases. Each week, veteran trial attorney Tom Crosley shares insights from over 15 years of brain injury litigation and 60+ trials—covering not just what worked, but why. Episodes dive into emerging trends, cutting-edge neuroscience, recent verdicts, and real courtroom strategies you can use. Get practical tips, expert interviews, and real-world analysis to help you win your next TBI case. New episodes drop every Tuesday, so you can make TBI Tuesday’s with Tom a regular part of your commute to the office.

  1. 6d ago

    Jury Selection in a Mild TBI Case with Robert Hirschhorn (Part 1)

    “If you can’t get the essence of your case to a jury in 30 minutes, then you have got to go back to the drawing board.” – Robert Hirschhorn Welcome to Winning The TBI Case, hosted by trial lawyer Tom Crosley. Listen as Tom provides practical, powerful guidance for litigating traumatic brain injury cases. This podcast is meant for litigation attorneys who are ready to explore the essentials of TBI cases to confidently represent clients who have suffered traumatic brain injuries. What’s In This Episode Tom is joined by Robert Hirschhorn, attorney and trial consultant from CEB Jury & Trial Consultants to talk about the keys to successful jury selection in a mild TBI case. Picking a Jury For Your Case Jury selection in a mild TBI case starts with a difficult challenge: your client looks normal. The headaches, the brain fog, the mood changes, the lost enjoyment of life – none of it shows up on imaging. So how do you find jurors who will believe what they can’t see? Jury consultant and attorney Robert Hirschhorn has spent more than 40 years helping trial lawyers answer that question. In this conversation, Robert explains how voir dire has changed since COVID, why 45-60 minutes is enough (and more may hurt you), and the one tool he calls “the 11th commandment” of jury selection. Key Takeaways Robert is direct about the goal: 80% of your voir dire time should be spent identifying jurors who distrust invisible injuries, not building rapport. He covers: Why your client should not be in the courtroom during jury selection The difference between picking a liability jury and a damages jury Why scaled 0-10 questions provide better information about potential jurors If you’ve ever walked out of jury selection worried you talked too much about money, or missed the juror who was never going to buy your case, this conversation will reshape how you plan your next voir dire.This is Part 1 of a two-part series. In Part 2, Robert returns to discuss jury selection in a severe TBI case. Connect Connect directly with Robert Hirschhorn at https://www.cebjury.com/about-us Subscribe to Winning The TBI Case on Apple Podcasts, Spotify, YouTube or wherever you get your podcasts.  Follow on Facebook, LinkedIn, and Instagram. And remember, don’t just listen to the strategies, implement them!

  2. Oct 15

    Representing the Incapacitated Client with Price Johnson

    “Most probate lawyers don’t know anything whatsoever about personal injury. They’ve never handled a personal injury case, don’t know how to, and don’t understand why you’re doing what you’re doing at all, and that can be dangerous.” – Price Johnson Welcome to Winning The TBI Case, hosted by trial lawyer Tom Crosley. Listen as Tom provides practical, powerful guidance for litigating traumatic brain injury cases. This podcast is meant for litigation attorneys who are ready to explore the essentials of TBI cases to confidently represent clients who have suffered traumatic brain injuries. What’s In This EpisodeTom is joined by Price Johnson, a Dallas probate attorney, and CPA who is the kind of specialist trial lawyers call when a severely injured client may lack the capacity to sign a contract or approve a settlement. Protecting Your Client, Your Contract, and Your Fee A severely injured TBI client walks through your door with a loved one by their side. The injury is clear. The case is real. But the client cannot sign your contract. What do you do? When do you act? And who is your client? Price Johnson walks through the practical realities of representing clients whose capacity is in question. He covers the three paths available to attorneys in these situations. He explains the “incapacity trap” that can turn strong damages proof into a procedural problem. And he reveals the specific reason why calling a probate specialist should happen earlier than most trial lawyers think. What’s at Stake At stake is more than procedure. In a contingency case, how do you protect your fee when a probate judge later gets a say in whether it was reasonable? Price walks through: The reason why one-third contingencies rarely get challenged Why higher contingencies do get challenged Why getting your engagement fee approved up front protects both your client and your firm If you’ve ever worried about whether your contract will hold up or your fee will survive probate court scrutiny, this conversation is for you. Connect Connect directly with Price Johnson: 214-468-9000 Subscribe to Winning The TBI Case on Apple Podcasts, Spotify, YouTube or wherever you get your podcasts.  Follow on Facebook, LinkedIn, and Instagram. And remember, don’t just listen to the strategies, implement them! Winning the TBI Case — Episode 24: Representing the Incapacitated Client Host: Tom Crosley Guest: Price Johnson Runtime: 39:37 [00:00] Price Johnson (cold open): Most probate lawyers don’t know anything whatsoever about personal injury. They’ve never handled a personal injury case, don’t know how to, and don’t understand why you’re doing what you’re doing at all. And that can be dangerous. [00:13] Announcer: TBI cases can feel like navigating uncharted territory. Your client’s injury is real, but proving it — that’s where the real challenge begins. If you’ve ever felt like you’re missing crucial pieces of the puzzle, you’re in the right place. Welcome to Winning the TBI Case, where Tom Crosley shares the insights he’s gained from over 60 injury trials. Not just the victories, but the lessons learned along the way that make all the difference. Winning the TBI Case: strategy, science, and storytelling. [00:48] Tom Crosley: Welcome back to Winning the TBI Case. I’m Tom Crosley, and today we are joined by Dallas attorney Price Johnson. Price is a CPA and a lawyer and represents business clients in business litigation. A significant portion of his practice is probate issues and probate litigation. And in particular, he helps personal injury lawyers deal with guardianship and probate issues that arise in their cases. What I’ve invited him on the show to talk about today is what we TBI lawyers need to be aware of when representing severely injured clients. In some cases, our client may lack capacity even to sign the original attorney-client contract. What do we do? How do we spot those issues? When do we act? At some point we might need court approval for certain activities in the case, including settlement. And so Price is the kind of lawyer that lawyers like me call when we have these issues in our cases. Price, how are you doing this morning? [01:50] Price Johnson: Tom, I’m great this morning. Thanks for having me on. It’s a privilege to be here with you. [01:55] Tom Crosley: What I’d like to do — for an audience that extends beyond the borders of the state of Texas — is frame the issue for us. When we have a more serious TBI case, let’s say we’ve just gotten it in to sign it up. What do we need to be aware of to make sure we’re doing it right? [02:15] Price Johnson: It’s a can of worms. There are a lot of things to do, and probably the most important thing I think a personal injury lawyer handling TBI cases can do is find out as many facts as possible. The place I would generally start is to try to find out what your client’s capacity is. Keep in mind, in my probate world — unlike the personal injury world, where so much of what we rely on is common law, where we go look up court cases and they tell us what the rules are, sometimes even the elements of our causes of action and claims — much of this is codified. It’s an old area, and a lot of it’s codified. So when I use terms like “incapacitated,” those are literally defined terms. So the first thing you want to make sure of is: who’s your client? Just as in any case, right? You want to make sure who your client is, because without a client, well, you don’t have a case, right, Tom? You don’t have a client to work for. So the first thing you’re going to do is try to figure out who the client is. And if the injured party that you’re trying to ultimately represent is incapacitated, you’ve got to find somebody with authority to hire you. [03:27] Tom Crosley: What is the significance to us TBI lawyers that probate codes exist, and that the law in probate is typically code-based as opposed to stare decisis–based? [03:43] Price Johnson: Well, one nice thing about it is some of these things you can look up — they’re actually rules, statutes that exist. For example, we all tend to rely on case law, or in my area, statutes, but also case law that interprets those statutes. But where I would tell you to be very, very careful — particularly, for example, you and I are in Texas — is the Rules of Civil Procedure. Lawyers come to me all the time and go, “Well, Texas Rule of Civil Procedure 151 or 152” — which I refer to as the dead plaintiff and dead defendant rules — “say this. They say I can just go file a suggestion of death, a motion for scire facias, serve the heirs, and I’m good.” Well, those are rules. They’re not statutes or case law, and they absolutely conflict with the statutes and case law, and you will walk right into a malpractice claim and no client. So there are pitfalls and traps to be aware of. And to go back to a question you were asking me a moment ago — trying to figure out who your client is — obviously in a TBI case, you’re presuming that your client’s not deceased. Not yet, and hopefully won’t be. So you’re not going to end up with, for example, an administrator or an executor of an estate, because that only happens when someone’s dead, right? What you’re going to have is possibly someone with a power of attorney, possibly a guardian of the estate. Then there comes the trick: how many of us have powers of attorney right now, while you and I are competent and have capacity? Most don’t. Most lawyers don’t, most people don’t — just like most people don’t have wills. So what are the odds that your fellow TBI lawyers out there are going to have someone walk in and say, “My husband, my son, my daughter, my parent, my whomever was seriously injured. They’re in the hospital with a TBI, or they’re in a coma right now and they can’t communicate because they don’t have capacity. But here, I’ve got this power of attorney.” I’m guessing that doesn’t happen for you a lot, does it, Tom? [05:51] Tom Crosley: No, not at all. Probably never. [05:53] Price Johnson: And so the trick then becomes: well, if they don’t have capacity right now, they can’t sign a power of attorney. So then you get into whether they qualify for a guardianship or not. And is the guardianship the right move — where you’re at least temporarily, possibly permanently, stripping the rights from that individual that has the TBI and vesting them in someone else? That’s certainly an option, but that takes time. It’s a process. And then, of course, in Texas we do have the next friend rule — Rule 44 in Texas. It also depends heavily on what the relationship is between the person coming to you and the injured party that lacks capacity. So there are a lot of different things you look at, but that’s where I would suggest everybody start: what are the facts of the capacity? How long is it expected to last? Are they going to come out of this in a week, hopefully, or is it unknown? How severe is it? Is it potentially permanent? And then what steps should we be taking, and who’s the party coming to you? What is their relationship with this person? That will help us figure out what the avenues are. [06:55] Tom Crosley: Let’s use a few case examples. Often I’ll get hired later in the process — maybe a referring attorney gets me involved. And so I had one case where it had already been going for maybe two years by the time I got involved. The wife was severely injured and was in a coma for 30 days. And while she was in a coma, her husband signed the personal injury contract with the lawyer, individually and as next friend of his wife. I was concerned about that, because she lacked capacity. Her r

  3. Aug 13

    Setting Up the TBI Case for Success: The First 6 to 18 Months

    One of the most common mistakes I see is lawyers screening for TBI will simply stop at asking the question, “Were you knocked unconscious?” – Tom Crosley Welcome to Winning The TBI Case, hosted by trial lawyer Tom Crosley. Listen as Tom provides practical, powerful guidance for litigating traumatic brain injury cases. This podcast is meant for litigation attorneys who are ready to explore the essentials of TBI cases to confidently represent clients who have suffered traumatic brain injuries. What’s In This Episode Tom Crosley lays out a practical timeline for developing a TBI case during the critical first 6 to 18 months. He explains how better intake questions, four specific symptom-tracking tools, and consistent symptom documentation can establish an early foundation while helping attorneys avoid gaps that may later create problems with proof. Building the Foundation of a TBI Case The success of a case often depends on decisions made in the earliest days, long before depositions, expert testimony, or trial. In this episode, Tom explains why the first six months matter enormously and what lawyers need to do during the first 18 months to shape the medical and legal framework of the entire case. Using a real case example, Tom demonstrates what can happen when persistent brain injury symptoms are not adequately documented early. He then walks through his approach to identifying potential TBI cases, tracking symptoms, and supporting accurate medical documentation. Key Insights for Trial Lawyers Go Beyond Loss of Consciousness: Intake forms should explore memory, confusion, altered mental status, acute symptoms, and what others observed immediately before and after the injury. Create a Written Symptom Record: Vague descriptions such as feeling “foggy” or “not myself” may not adequately capture what a client is experiencing. Written symptom questionnaires can help clients organize their symptoms and communicate them more accurately to their treating physicians. Tom recommends the following four symptom forms: Philadelphia Head Injury Questionnaire (PHIQ) CDC Acute Concussion Evaluation (ACE) Rivermead Post-Concussion Symptoms Questionnaire (RPQ) Headache Impact Test (HIT-6) Avoid Gaps in Medical Documentation: Persistent symptoms need to reach the treating physician. Long periods without meaningful documentation can make an otherwise legitimate injury significantly more difficult to prove later. Know When to Expand the TBI Workup: For clients with persistent symptoms, Tom discusses when to consider advanced neuroimaging and whether a neuropsychological evaluation is warranted. Reassess as the Case Develops: As the case progresses into the 12-to-18-month window, repeat neuropsychological testing or neuroimaging may help document whether the client’s condition has improved, remained stable, or changed over time. For Trial Lawyers: Build the Foundation Early This episode is for trial lawyers who handle serious injury cases but may not regularly litigate TBI cases. Tom’s message is simple: Start early Ask better questions Document symptoms Make sure those symptoms are reaching treating physicians Continually evaluate whether the developing medical evidence supports the TBI case The goal is not to overbuild every potential brain injury claim. It is to recognize legitimate TBI cases early enough to develop the medical and factual record needed to accurately demonstrate the client’s injury when the case reaches trial. Connect Subscribe to Winning The TBI Case on Apple Podcasts, Spotify, YouTube or wherever you get your podcasts.  Follow on Facebook, LinkedIn, and Instagram And remember, don’t just listen to the strategies, implement them! Winning the TBI Case — Episode 23: Setting Up the TBI Case for Success: The First 6 to 18 Months Crosley Law | Aired: August 13, 2026 | Runtime: 29:37 | Speakers: Narrator, Tom Crosley [0:00] Tom Crosley: One of the most common mistakes I see is lawyers screening for TBI will simply stop at asking the question, “Were you knocked unconscious?” [0:11] Narrator: TBI cases can feel like navigating uncharted territory. Your client’s injury is real, but proving it, that’s where the real challenge begins. If you’ve ever felt like you’re missing crucial pieces of the puzzle, you’re in the right place. Welcome to Winning the TBI Case, where Tom Crosley shares the insights he’s gained from over 60 injury trials, not just the victories, but the lessons learned along the way that make all the difference. Winning the TBI Case: Strategy, Science, and Storytelling. [0:46] Tom Crosley: Welcome back to Winning the TBI Case. I’m your host, Tom Crosley, and today I’d like to talk about how to set your case up for success in the first six months. Because let’s face it, a lot of times a TBI case at trial will only do as well as the foundation that was laid in the early days of that case. Let me tell you what I mean. At trial, we often think about expert witnesses, neuropsychological testing, how well did we prepare for depositions, how well did we pick our jury, but all of that is less important than how well we set our case up for success in the early days. The quality of the intake, the questions we ask our clients at the beginning, the way the client’s symptoms are documented, all those steps taken in the first six months of a case will often determine how successful that case is at trial two or three years later. So I’m speaking now to lawyers that may handle serious injury cases but don’t handle a high volume of TBI cases, and I’m going to provide some tips on how I usually set these cases up for success early. The central point is this: in a TBI case, especially a mild TBI case, the first six months matter enormously, and the first eighteen months or so often define the medical and legal architecture of the entire case. [2:13] Tom Crosley: Let me begin with a case example about the problem with being too late to recognize your case as a TBI case. Several years ago, I was referred a case involving a young college-aged woman who’d been in a serious intersection collision. This was not a minor crash. She had been unconscious for briefly a minute or two. She had some bleeding on the scalp. She had a laceration. She even had a small spot of bleeding within the brain. She was taken to the hospital in an ambulance. In the hospital, the CT scans showed some abnormality, but a few weeks later she had an MRI, and by that time the blood seen on the CT was gone, and the MRI was read as normal. And the doctor told her, “Hey, look, I know you’re having these symptoms, but it’s probably all gonna go away in six weeks or so,” and no follow-up appointment was ever made, and then I get the case two years later. And so I, first thing I do is I meet with the client, and I learn that she’s still got memory trouble. She’s got headaches. Sometimes the headaches are so bad that she has to go into her boss’s office where she works in a copy center at the university, and she has to lay down on the couch and turn off the lights because these are migraine-type headaches. [3:32] Tom Crosley: She didn’t used to have these before the crash, and so this was a life-changing injury for her. The problem is she hadn’t seen a doctor about it in almost two years. And so when I got involved, I certainly encouraged her to go back to the doctor and start reporting these symptoms. The problem with it was the defense took it all as lawyer-generated medicine. “Hey, this client was fine. She didn’t really need to go to the doctor again until Crosley got involved and started representing her on the case.” That wasn’t fair, but that’s what we were dealing with in that case. She had all these post-concussion symptoms. She had classic post-concussion syndrome that, in her case, was unresolved after two years and would likely be permanent, but it wasn’t adequately documented in the medical records. So when there is a long period of time with little or no meaningful documentation about the brain injury symptoms, that creates a problem for our proof. She had seen other doctors in that span of time. She had been to doctors for routine medical care visits, but none of these other symptoms that she was supposedly having were documented, and certainly not documented in a way that supported the full picture of what she was experiencing. [4:48] Tom Crosley: In that case, I had to rely on friends, family members, coworkers to help explain that these symptoms were legitimate, they were real, they persisted all the time. But it sure would have been nice if there had always been a medical doctor checking in with her every ninety days or so and documenting her ongoing symptoms in a medical record. So from a litigation standpoint, the defense argument was very predictable. Hey, if these symptoms were real and they were significant, why was there nearly two years with no documentation of any TBI related symptom? That was a problem in the case. The case ultimately settled, but for less than it would have if we had set it up for success in the first six months. The gap in those records made the case much harder than it needed to be. Had I received that case weeks after the crash instead of more than two years later, the development of the case would have looked very different. As long as she remained symptomatic, she would have had someone encouraging her to follow up with her doctors and tell them what she was experiencing. Someone would have been tracking her symptoms. Someone would have been considering whether advanced imaging or neuropsychological testing was appropriate. [6:05] Tom Crosley: Someone would have made sure the medical record reflected the

  4. Jun 26

    Exposing the Defense Expert Playbook with Dorothy Clay Sims

    Defense experts often rely on a familiar set of arguments in traumatic brain injury cases. The challenge for plaintiff lawyers is knowing how to identify those themes and effectively challenge them. Welcome to Winning The TBI Case, hosted by trial lawyer Tom Crosley. Listen as Tom provides practical, powerful guidance for litigating traumatic brain injury cases. This podcast is meant for litigation attorneys who are ready to explore the essentials of TBI cases to confidently represent clients who have suffered traumatic brain injuries. This episode is for plaintiff lawyers who want to recognize and dismantle the predictable defense expert playbook in TBI cases. Dorothy Clay Sims reveals the recurring tactics they use and shares the research methods to expose their weaknesses. In this episode, Tom sits down with attorney Dorothy Clay Sims, author of Exposing Deceptive Defense Doctors and a nationally recognized authority on defense medical testimony. Drawing on decades of experience, Dorothy discusses the recurring strategies she sees in TBI litigation and the patterns that appear again and again in defense opinions. She also shares practical steps lawyers can take to identify weaknesses in those opinions and build a stronger case for their clients. Dorothy shares insights on: Looking beyond the medical record to uncover critical evidence Challenging imaging and neuropsychological opinions effectively Researching and evaluating defense experts Preparing for deposition with a strategic purpose Avoiding common mistakes that can undermine a TBI case Whether you’re new to TBI litigation or looking to sharpen your approach, this episode offers practical guidance for recognizing and responding to the defense playbook. Connect Connect directly with Dorothy Clay Sims: https://dorothyclaysims.com Mentioned: Exposing Deceptive Defense Doctors Subscribe to Winning The TBI Case on Apple Podcasts, Spotify, YouTube or wherever you get your podcasts.  Follow on Facebook, LinkedIn, and Instagram. And remember, don’t just listen to the strategies, implement them! Winning the TBI Case — Episode 22: Exposing the Defense Expert Playbook  Host: Tom Crosley Guest: Dorothy Clay Sims Runtime: 35:58 [00:00] Dorothy Clay Sims (cold open): What we found out recently in a case in California is the defense expert altered the test administration and/or changed our client’s answers 67 times during the examination.  [00:12] Announcer: TBI cases can feel like navigating uncharted territory. Your client’s injury is real, but proving it is where the real challenge begins. If you’ve ever felt like you’re missing crucial pieces of the puzzle, you’re in the right place. Welcome to Winning the TBI Case, where Tom Crosley shares the insights he’s gained from over 60 injury trials. Not just the victories, but the lessons learned along the way that make all the difference. This is practical wisdom from someone who’s been in your shoes and found a path forward. Winning the TBI Case: strategy, science, and storytelling.  When Dorothy Clay Sims discovered that defense experts were systematically lying about her brain injury clients, she made it her life’s work to expose their deceptive tactics. In this eye-opening interview, Dorothy shares the tools every trial lawyer needs to identify and challenge fraudulent medical testimony.  [01:18] Tom Crosley: Welcome back to Winning the TBI Case. I’m Tom Crosley. Today’s guest is Dorothy Clay Sims. She’s a lawyer who has spent decades studying how defense medical experts operate: how they write their reports, how they testify, tactics they use to minimize or deny injury claims. And if you’ve ever read a defense IME report and thought, “Oh, here we go again,” then this episode is for you.  We’re gonna walk through what Dorothy actually does for trial lawyers, when you should consider retaining her, what you can learn from her, and hopefully give a practical framework for researching a defense doctor and building a cross-examination strategy that’s clean, fair, and powerful. All of this without turning the courtroom into a boring medical seminar. So let’s get into it. Dorothy, how are you doing today?  [02:13] Dorothy Clay Sims: I’m good. How are you doing, Tom?  Tom Crosley: I’m doing great. So you and I have known each other for, gosh, a long, long time. Almost 20 years now — more than 15 years for sure. A lot of your background I’m familiar with, but we may have listeners who aren’t. So I wanted to start with: what drew you into studying defense medical testimony in the first place, carving out this niche in your law practice?  [02:42] Dorothy Clay Sims: Well, my motivation, actually, it’s this guy right here. His name was David Hansford Sims. He was my brother. He had a very severe disability. He could not ever speak, communicate. He would sit for hours on end shaking a sock. And I saw how he was treated, and it really bothered me. And I felt like I wanted to represent disabled people.  And then the more I did it, the more defense reports I got, the more I realized these people are lying. And so one day, after 60 cases in a row where the same doctor said my clients were faking based on the MMPI, I went and met the creator of the MMPI, and I showed him the last report, and he started laughing. And I said, “What’s so funny?” And he said, “If this doctor had been my student, I would have failed him. This is not an appropriate interpretation of the test.”  I knew that they were lying — defense experts in general — but I didn’t know how. And so he actually became a friend of mine, and we spent hours together, and he would give me examples, questions to ask, and this is how they manipulated the science.  And I ended up doing a lot of brain injury work because there’s neuropsychological testing, and that is an area where I’ve seen incredible fraud. What we found out recently in a case in California is the defense expert altered the test administration and/or changed our client’s answers 67 times during the examination. It got so bad that during the cross-examination, the judge says, “Okay, you can stop. We know they did it all wrong.” We didn’t want to stop, but it was terrible. So the more I get into this, the angrier I get.  I spent several years taking all these tests myself, having physicals performed on me to understand how those are altered. And then I worked closely with my husband, who’s a physical medicine and rehab doctor, and he ran a brain injury clinic. And he watches the videotapes of the defense medical exams, looks at the report, and then he goes into the body of the report and lists everything they misrepresented based on the video. He’s done probably 700 of these. And when I asked him what percentage of the time the doctor actually accurately reflected what happened in the report — knowing that they were being recorded — the answer is zero.  [05:06] Tom Crosley: Some years ago, you wrote a book called Exposing Deceptive Defense Doctors. I actually bought that book, gosh, 20 years ago maybe. I don’t remember when it was published. But it was one of those three-ring binder books that was multiple volumes, very expensive for a young lawyer at the time. But I recall that book being instrumental in helping me approach defense IMEs. This was not brain injury cases; these were typically spine injury cases.  Dorothy Clay Sims: Right.  Tom Crosley: But since that time, it sounds like you’ve been doing a lot of work on brain injury cases.  [05:39] Dorothy Clay Sims: Yeah, and that book has had significant updates. It’s probably twice as long. I have a lot of references to diffusion tensor imaging — I know you had a piece on that. There’s a lot of politics going into articles that are written saying don’t use it. It’s unbelievable in that field what’s happening. But yeah, the book is longer and there’s a lot more updated information in it.  [05:57] Tom Crosley: I need to get it. So we had as a previous guest Stewart Casper, who you and I both know very well. And he and I talked about the concept of the citation cartel.  Dorothy Clay Sims: Yes.  Tom Crosley: So I’m assuming that’s a little bit of what you’re referring to in your previous comment just now.  [06:14] Dorothy Clay Sims: Well, there is such a thing. And in fact, one of the problems we have is people are afraid to talk about it, especially professionals, because a certain number of defense experts are very litigious. But yeah, when you have a defense expert become the head of a journal, deciding what gets published and what doesn’t, and that individual doesn’t even allow an article published by the creator of a test that is being analyzed and criticized in that journal — they don’t allow the test creator to weigh in. It’s bad.  [06:41] Tom Crosley: I know you speak a lot around the country and even internationally, and I’ve heard you speak several times. You’re always very entertaining. Some of the examples you give are so incredibly outrageous as to defy belief.  Dorothy Clay Sims: Yes.  Tom Crosley: And I haven’t had those examples actually appear in my cases, because I’m usually dealing with pretty known quantities. I mean, I’ve had you do opposition research for experts. You provided packets of information. But what I’d like to hear is the normal — what are you doing for lawyers like me, either by helping us prep for these defense experts, or sometimes, I know, you’ll come in and do them yourself as part of our case? Help us understand what you’re doing when you don’t have this crazy outlier who’s lied on his résumé and put in degrees that he doesn’t have and things like

  5. May 27

    Defusing GCS in a Mild TBI Case

    “GCS is not looking at long-term outcomes. It’s looking at that little slice in time right after the injury happened in the acute phase.” – Tom Crosley Welcome to Winning The TBI Case, hosted by trial lawyer Tom Crosley. Listen as Tom provides practical, powerful guidance for litigating traumatic brain injury cases. This podcast is meant for litigation attorneys who are ready to explore the essentials of TBI cases to confidently represent clients who have suffered traumatic brain injuries. What’s In This Episode: Tom Crosley explains how the Glasgow Coma Scale (GCS) gets weaponized by defense attorneys in mild TBI cases. He breaks down what GCS actually measures, why it was created, and how to defuse defense arguments that use normal GCS scores to discredit legitimate brain injury cases. Defusing the Defense Weapon This is for trial lawyers who need to understand why a normal GCS score doesn’t mean their client wasn’t injured. Tom reveals how defense attorneys take one number from acute medical records and use it to undermine entire cases. He explains the historical context of GCS which was created in 1974 as a bedside tool designed for neurosurgeons to assess coma depth and decide on emergency surgery, not to predict long-term outcomes. GCS measures three basic functions: Eye opening Verbal response Motor commands All tests that any elementary school student or family dog could pass. Tom provides the analogies and cross-examination techniques to expose how this acute triage tool has zero relevance to how patients function years later in life. By understanding what GCS actually measures (and what it doesn’t), you have the power to educate juries and neutralize one of the defense’s favorite, and often misleading, arguments. Connect Subscribe to Winning The TBI Case on Apple Podcasts, Spotify, YouTube or wherever you get your podcasts.  Follow on Facebook, LinkedIn, and Instagram And remember, don’t just listen to the strategies, implement them! Winning the TBI Case — Episode 21: Defusing GCS in a Mild TBI Case Crosley Law | Aired: May 27, 2026 | Runtime: 20:24 | Speakers: Narrator, Tom Crosley [0:00] Tom Crosley: A GCS is not looking at long-term outcomes. It’s looking at that little slice in time right after the injury happened in the acute phase. [0:09] Narrator: TBI cases can feel like navigating uncharted territory. Your client’s injury is real, but proving it, that’s where the real challenge begins. If you’ve ever felt like you’re missing crucial pieces of the puzzle, you’re in the right place. Welcome to Winning the TBI Case, where Tom Crosley shares the insights he’s gained from over 60 injury trials. Not just the victories, but the lessons learned along the way that make all the difference. Winning the TBI Case: Strategy, Science, and Storytelling. [0:45] Tom Crosley: Welcome back to Winning the TBI Case: Strategy, Science, and Storytelling. I’m Tom Crosley. Today I want to talk about the Glasgow Coma Scale, or GCS, and why it gets misused in mild traumatic brain injury cases. Here’s how this usually shows up in litigation. The defense will point to a normal GCS score in the EMS record or the ER record and say, therefore, ladies and gentlemen of the jury, this was not a significant head injury. There’s no good explanation for the symptoms that allegedly persisted because look, we have this normal GCS score on the day of. And so that’s the defense move. They take one number from the acute medical records and they try to use it to discredit the entire case. If nobody explains what the GCS actually measures, what it was designed for, then that defense argument can sound stronger than it really is. Jurors might hear normal neurological score and assume it means the brain was fine. But that is not what the Glasgow Coma Scale was designed to measure. So let’s talk about a little historical context. It was first introduced in 1974 in Glasgow, Scotland by two neurosurgeons. [2:01] Tom Crosley: They were really looking for a common language for doctors to use as a bedside tool that would help them communicate about a patient’s level of consciousness after acute brain injury. And in particular, when it would become important to call a neurosurgeon. Because maybe the neurosurgeon might have to do some life-saving surgery. That was the original mission. How awake is this person? How responsive are they to simple commands? And are they getting better or worse? So that matters because it tells you the lane that this GCS tool was originally built for. Acute assessment in the minutes or hours following the injury. Bedside communication. Triage. Later, researchers began using GCS scores to correlate severity grading and long-term patient outcomes because GCS became very popular. It’s used worldwide. It’s been cited 37,000 times in the medical literature. So it’s definitely the most common neurological assessment tool in the acute phase. So you’re going to see it in your medical records. You’re going to see it in your cases. So with all that data, researchers who study long-term outcomes for TBI, ranging from severe to moderate to mild, will often look back at what was that early GCS score. [3:22] Tom Crosley: And we learn in the mild category that long-term outcomes are not predicted by GCS score. We learn with moderate and severe injuries, long-term poor outcomes are more predictive based on GCS score. So let’s talk about the name itself because the name matters. If we’re teaching it to a jury, it is the Glasgow Coma Scale. Coma. It’s not the Glasgow Executive Function Scale. It’s not the Glasgow Working Memory Scale. It’s the Coma Scale. It is fundamentally a scale of responsiveness and depth of impaired consciousness. The lower the score a person has, then the more deep their coma. It’s measuring three domains. Eye response. Are the person’s eyes open spontaneously or are they closed? Are they out? And now if they are out, do they open in response to a verbal command? If not, do they open when we give them some noxious stimuli? For example, we rub their sternum. Does that make their eyes open? These are testing levels of depth of coma. Verbal response is the second of the three things they’re looking at. Are they oriented normally? Do they know where, in broad strokes, where they are, what year this is, what city they are in? [4:44] Tom Crosley: Literally, those are the types of questions. Or are they unable to make any sounds because they’re out of it, they’re in a coma? Or are the sounds they’re making guttural and incomprehensible? That’s kind of what they’re looking for on the verbal side. When I see an abnormal GCS in a mild case where they lose a point or two points, it’s almost always on the verbal side. And it’s because the patient is confused. They’re not completely oriented. They might be asking the same question over and over again and not really responding to the examiner’s very basic questions. The third thing that GCS is looking at, remember number one, eyes, number two, verbal, number three is motor response. Can the person obey simple commands? So all the way from no motor response whatsoever, out completely cold, to extension or flexion in response to painful stimuli or trying to withdraw from pain. Again, that sternum rub can be useful there. Or can the person obey simple commands? So I’m typically seeing in the mild case four out of four for eye response, six out of six for motor response, and usually five out of five for a total score of 15 for the verbal response. [6:01] Tom Crosley: Sometimes I’m seeing a four out of five on the verbal response because the person is clearly confused at the scene and keeps repeating themselves. All right. So what is that telling us? When I teach it in CLE, I will often put up a slide showing a doctor talking to a patient on an exam table. And that patient’s sitting there and he’s got his eyes open and the doctor’s holding a clipboard and a stethoscope around his neck wearing a white coat. And I’ll say, “This is what a normal GCS looks like.” And while that slide’s still up, I’ll tell the audience something like this. I’ll say, “You know, I don’t care how much I’m boring you right now. I could be the most boring speaker you’ve ever heard in your entire life. You could be on the verge of falling asleep, but if your eyes are still open, if you’re sitting in this room listening to me, you have a normal GCS.” And then I’ll say, “Do you know what else has a normal GCS?” And then I’ll advance the slide and it’ll be a picture of my dog, a chocolate lab. And that’s the part that gets the laugh. And it works because this point kind of hits home. My dog, his eyes opened spontaneously. [7:16] Tom Crosley: Remember the eyes were category one. The second was verbal response, but it’s really testing is the patient oriented to time, place, and person. And so my dog knows where his food bowl is. He knows where his bed is. He can bark on command. So he’s kind of passing that one too. And then motor response. He can sit. He can shake hands. He can roll over. My dog can pass that one too. So how high is the bar to get a normal GCS? That’s my point. And that’s why this joke kind of hits home. I even got to do it once in a trial. I had a well-known and sneaky defense expert on the stand in trial in Houston. And he was harping on the normal GCS on day one for my patient. And here we are three years later and he’s trying to say this normal GCS somehow means that this patient should be well by now. And so I showed the slide, got the doctor to admit, “Yep, that’s a normal GCS.” Got him to admit that everybody in the courtroom, all the people on the jury, the people in the gallery, thos

  6. May 6

    A Radiologist’s Approach to TBI Case Evaluation – Dr. David Levey

    “What I’m looking for is: What is the correct diagnosis? What happened to this patient? Is he or she being treated correctly or properly? And that’s a concern of mine.” – Dr. David Levey Welcome to Winning The TBI Case, hosted by trial lawyer Tom Crosley. Listen as Tom provides practical, powerful guidance for litigating traumatic brain injury cases. This podcast is meant for litigation attorneys who are ready to explore the essentials of TBI cases to confidently represent clients who have suffered traumatic brain injuries. Tom is joined by Dr. David Levey, a diagnostic radiologist and forensic neuroradiology expert who evaluates traumatic brain injury cases for both plaintiffs and the defense. Dr. Levey walks through the detailed process radiologists use to evaluate imaging, medical records, symptoms, and clinical history when analyzing TBI cases in both medical and litigation settings. What’s In This Episode Dr. David Levey explains how radiologists evaluate traumatic brain injury cases and how imaging findings fit within the broader clinical and litigation picture. He also shares practical insight into the role imaging plays in TBI litigation and best practices for trial lawyers working with radiology experts. Key Insights for Trial Lawyers Radiologists Evaluate More Than Images: Forensic radiology involves an extensive analysis of imaging combined with medical records, symptoms, clinical history, and causation evidence in context. “Normal” Scans and Imaging Do Not Rule Out TBI: There are times when traumatic brain injuries will not appear on routine CT imaging. MRI studies can reveal subtle abnormalities not visible on CT scans. Advanced imaging such as DTI, tractography, and volumetric imaging can provide additional detail and should always be considered alongside symptoms, testing, and functional changes. Effective TBI Litigation Requires Collaboration: Radiologists often work closely with attorneys and other experts to help evaluate complex brain injury cases. Dr. Levey pulls back the curtain on the detailed analytical process radiologists use to evaluate brain injury cases in both medical and forensic settings and shares how he works with both plaintiff and defense teams. Preparation Matters This episode is for trial lawyers who want a clearer understanding of how radiologists evaluate traumatic brain injury cases and how imaging evidence fits into litigation strategy. If you’ve ever struggled with “normal imaging” defenses or wanted insight into how to best leverage your radiology experts in TBI cases, then you’ve come to the right place. Referenced and Mentioned Dr. Levey and Tom reference tractography imaging beginning at time code 22:49 which can be seen on the video version of the podcast. Screenshots below for our audio listeners. Connect Connect directly with Dr. David Levey by visiting: www.expertradiologist.org Subscribe to Winning The TBI Case on Apple Podcasts, Spotify, YouTube or wherever you get your podcasts.  Follow on Facebook, LinkedIn, and Instagram And remember, don’t just listen to the strategies, implement them! Winning the TBI Case — A Radiologist’s Approach to TBI Case Evaluation  Host: Tom Crosley Guest: Dr. David Levey Runtime: 37:08  [00:00] Dr. David Levey (cold open): Follow-up MRIs can be valuable, particularly in two cases. One, if you have found nothing abnormal on imaging structurally, right? Yet the patient is so abnormal. The family doesn’t recognize them anymore. Work’s not going well. The tasks they used to do, they can’t do them anymore. Well, you know something’s wrong.  [00:20] Announcer: TBI cases can feel like navigating uncharted territory. Your client’s injury is real, but proving it — that’s where the real challenge begins. If you’ve ever felt like you’re missing crucial pieces of the puzzle, you’re in the right place. Welcome to Winning the TBI Case, where Tom Crosley shares the insights he’s gained from over 60 injury trials. Not just the victories, but the lessons learned along the way that make all the difference. Winning the TBI Case: strategy, science, and storytelling.  [00:55] Tom Crosley: Welcome back to Winning the TBI Case. I’m Tom Crosley, and today we’re gonna have an exciting episode. We’re gonna be talking about one of the most misunderstood areas in traumatic brain injury litigation, and that is brain imaging. Our guest today is Dr. David Levey, a diagnostic radiologist with a clinical practice reading brains and spines, and he also happens to serve as an expert witness from time to time in legal cases. About half of his work is on the defense side; about half is on the plaintiff side. So he’s one of those expert witnesses who is exactly what we want: science first, advocacy second. Somebody who does both sides and calls the balls and strikes like he sees them.  I wanted to start with a little bit about you and your background. What led you to go to medical school? How did you pick radiology as your specialty? Kind of bring us current to modern times.  [01:59] Dr. David Levey: Well, when I was 11, I read a book called The Defense Never Rests, and that was it. I was going to be a lawyer. And in the next few years, that evolved. I went to college, got two different bachelor’s degrees, really heading towards the neurosciences, and a master’s degree at UCLA before medical school. Then after medical school: internship, a trauma internship, four years of radiology at USC, and a fellowship. After 17 years coming out of the machine, I finally got my first job doing just that — neuroradiology, musculoskeletal imaging — here in Texas. That was the first job, and here I am.  [02:45] Tom Crosley: Tell us about how forensic neuroradiology — for example, in a brain injury case — differs from day-to-day clinical neuroradiology.  [02:53] Dr. David Levey: It’s extraordinary, the difference. I didn’t know about it until I started this 15 years ago. If you’re reading an MRI of the brain as a radiologist, you get the case; the case comes up. You get some clinical data. You may get some clinical information faxed to you. Some of it’s sketchy, some of it’s from the patient. You may get some nursing notes, from the PA or the doctor, but it’s variable. If you get 10 pages of notes, you’re really doing great. If you get a page or two, that’s acceptable too. Many of the diagnoses are fairly complete, and others may have “headache” or “head pain” or “trauma” — no date, no description, no time. You don’t have any idea.  So you are absolutely starting from the beginning and working your way through the brain MRI and trying to get that diagnosis. So you’re looking for everything under the sun. You can’t focus on trauma or anything. And that takes you X amount of time. You know, a brain MRI may take two minutes or two hours. I’ve had one take two days — spent two days on it, getting through it, it was so complicated. But it’s a finite experience.  But forensic radiology — you get reams of medical records and a number of opinions from everywhere. From the police report at the scene of the accident, all the way through the ER and the ICU and the consultants and surgery or not. Then the patient finally is released from the hospital and has all these follow-up appointments with many other experienced, seasoned experts: pain people, clinical psychology people, PM&R, et cetera. And the vast amount of information I can use to put a story together is what I think attracted me at first to this field. All the imaging available plus all the medical records together allows me to tell a story — not only with the radiology and the imaging, but the medical process and the path the patient took as well.  [04:57] Tom Crosley: Some radiologists that serve as expert witnesses don’t like to look at medical records. They just want to look at the imaging and dictate a report based on what they see. But it sounds like you like to look at the whole picture, including medical records. Why is that?  [05:10] Dr. David Levey: I think it’s important. I do like it, you’re right. But I also think it’s important. I think you’re missing something if you’re not doing that, because, first of all, from the correct diagnosis flows the correct treatment. I want to get involved with any patient — it doesn’t matter, defense, plaintiff, or whatever the situation is. What I’m looking for is: What is the correct diagnosis? What happened to this patient? And is he or she being treated correctly or properly? And that’s a concern of mine.  Because I see that if the radiologist who read the primary studies got it wrong, the whole crowd — medical, surgical, everybody — they’re following down the wrong pathway. And that’s the classic GIGO I see all the time: garbage in, garbage out. You get the wrong diagnosis, and there’s surgery in the wrong place, or no surgery where he needs it, or treatment that is inappropriate because the diagnosis was not made correctly in the beginning. So medical records really help with that. You hardly ever get that when you just get a case, read it, get a case, read it, like in a radiology practice.  [06:15] Tom Crosley: It sounded like your explanation of the difference between clinical radiology and forensic radiology was that sometimes, clinically, you might only spend a few minutes reading a brain scan, but if it’s forensic — meaning it’s going to be used in a court case — then you’re going to spend probably a lot more time. Is that what I’m hearing?  [06:35] Dr. David Levey: I do, and I see them over and over again, because it may take weeks to get the consultative report out. B

  7. Apr 14

    Inside an $8.1 Million TBI Verdict with Scott Blair

    “ The TBI alters the organic chemistry, the physical structure of the brain to the point where our personalities then get altered. Our spirit knows who we are. But you can’t get that person back… and I think jurors get that.” – Scott Blair Welcome to Winning The TBI Case, hosted by trial lawyer Tom Crosley. Listen as Tom provides practical, powerful guidance for litigating traumatic brain injury cases. This podcast is meant for litigation attorneys who are ready to explore the essentials of TBI cases to confidently represent clients who have suffered traumatic brain injuries. What’s In This Episode: Scott Blair shares how he built and tried a complex TBI case that resulted in an $8.1 million verdict.He explains the role of advanced neuroimaging, expert strategy, and objective evidence in overcoming common defense arguments. Most importantly, he provides practical guidance on how trial lawyers can strengthen their cases by understanding the medicine, telling the client’s story, and preparing for trial from day one. Winning Complex TBI Cases In this episode, Tom is joined by Scott Blair, founder of Brain Injury Law of Seattle, to break down the strategy behind a recent $8.1 million traumatic brain injury verdict. Scott shares how he approaches complex cases, from digging deep into the medicine to building objective evidence that makes it difficult for the defense to deny brain injury. This conversation goes beyond theory. Scott walks through the real decisions that shaped the case, including expert selection, advanced neuroimaging, trial strategy, and how to handle common defense tactics in high-functioning TBI clients. Key Insights for Trial Lawyers Dive deep into the medicine: The strongest TBI cases are built by lawyers who understand the underlying medical science and work closely with the right experts. Objective evidence changes the game: Advanced imaging, sleep studies, and vestibular testing can create converging proof that is difficult for the defense to dismiss. High-functioning clients require a different strategy: Clients who continue working after injury often face skepticism. Demonstrating how their capacity has changed is critical. Tell the employer early: Encouraging clients to disclose their brain injury can lead to documentation and accommodations that strengthen their case. Neutralize defense narratives early: Address issues like travel photos or work performance before the defense raises them to reduce their impact at trial. Use real-world functioning, not just testing: Speech-language pathology and real-world observations can be more persuasive than traditional neuropsychological testing alone. Before and after witnesses are critical: Family members, especially spouses, provide powerful testimony about how the client has changed after the injury. Visual evidence matters: Jurors respond strongly to clear visual representations of brain injury, especially when complex science is involved. This episode is for trial lawyers who want to take their TBI cases to the next level. If you’re handling complex or high-value cases, Scott Blair’s approach offers a practical roadmap for building stronger evidence, overcoming defense strategies, and presenting a compelling case at trial. Winning the TBI Case — Inside an $8.1 Million TBI Verdict with Scott Blair Crosley Law | Runtime: 50:10 | Speakers: Narrator, Tom Crosley, Scott Blair [0:00] Scott Blair: You know, what I told my client early on, because this is so typical of high-functioning people, they don’t want other people to know that they have a brain injury because it damages their employment reputation. They might lose their job. And it’s really important for us as plaintiffs, TBI lawyers, to tell our clients, no, do the exact opposite. [0:20] Narrator: TBI cases can feel like navigating uncharted territory. Your client’s injury is real, but proving it? That’s where the real challenge begins. If you’ve ever felt like you’re missing crucial pieces of the puzzle, you’re in the right place. Welcome to Winning the TBI Case, where Tom Crosley shares the insights he’s gained from over 60 injury trials. Not just the victories, but the lessons learned along the way that make all the difference. This is practical wisdom from someone who’s been in your shoes and found a path forward. Winning the TBI Case: Strategy, Science, and Storytelling. In this in-depth conversation, Tom Crosley welcomes Scott Blair to explore what it takes to win complex TBI cases that other lawyers won’t touch. [1:12] Tom Crosley: Welcome back to Winning the TBI Case. I’m your host, Tom Crosley. Today we are joined by Scott Blair, founder of Brain Injury Law of Seattle. For Scott, brain injury work is his passion. And for the last 25 years, he has proudly helped folks with brain injuries get the specialized treatment they need, and he has successfully litigated their claims in court cases time and time again. We’re really glad to have Scott here today because he’s going to discuss with us a very significant case he tried that yielded an $8.1 million verdict. I was hoping you could give us your background story. Talk about your life. What led you to law school? Then after law school, how did you end up becoming a brain injury lawyer? [2:01] Scott Blair: I was not a very good student in high school. I kind of failed out and just didn’t really care about it and decided to travel the world. But when I did that and got back and went to college, I wanted to be a doctor and my first semester I took Biology and got a C in it. And the pre-med advisor, I’ll never forget, he came over and put his arm on my shoulder and said, Scott, I don’t think medicine’s for you. And so ended up gravitating to law school instead and off I went. But you know, I was doing PI work early on in my career and did a lot of the musculoskeletal stuff, which is great. It’s just that there’s kind of a ceiling in terms of what you can learn about medicine. What really projected me into getting into some of these oddball you know, esoteric medical issues like brain injury was a case I had where nobody could figure out how my guy became a quad, and I won’t spend a lot of time on it, but he had this rare condition from a post-injury tetanus shot that he got called Chronic Inflammatory Demyelinating Polyradiculoneuropathy. So CIDP for short. And it took me seven years working with a neurologist to establish causation and get that thing up. We ended up getting a very good result for this kid that no one else was going to touch. [3:24] Scott Blair: And that case taught me a valuable lesson that really have to dive deep in the medicine. And so when I started doing TBI cases, I thought, oh my God. This stuff is fascinating as hell because, you know, musculoskeletal, you can only go so far with strains, breaks, and blah. With TBIs though, that stuff was just a total terra incognita, so to speak. And it just really stoked my curiosity. And every time you get into these cases, there’s something new and different, and you get some downright bizarre cases now and then. You know, you just don’t see any place else. They’re a great challenge trying to find how do you get the right experts for these things? You know, and for example, brain injuries, I’ve had two cases where it resulted in a loss of religiosity, for example, which is a really bizarre thing, but I was able to find a guy out of Northwestern University who actually has written papers on this. And so it’s a real thing. Mm-hmm. The challenge was how do you establish damages for a deeply religious family, who one member of the family is suddenly the whole sense of religiosity is gone. And it was. It’s that kind of stuff that is just really bizarre and interesting to me that drew me to TBIs. [4:45] Scott Blair: I’m a geek. I really dig, you know, diving into the other things, the pituitary stuff. I think we got the first pituitary verdict, post-traumatic hypopituitarism verdict in the country. And that just kind of fell in my lap. And we wouldn’t have gotten that without really digging deep into the medicine. [5:05] Tom Crosley: That’s interesting. I’ve not heard of the loss of religiosity. But as you were saying it started to make sense to me because a life-changing injury, especially a brain injury, becomes an existential crisis for the victim. And when you start to question your existence and how you’re going to live the rest of your life, I can see why it might lead one to, claim. [5:28] Scott Blair: You know, actually, Tom, it results from damage to the area of the brain that allows for and facilitates deep beliefs in things. And religion happens to be one of those. And that’s why this neuroscientist from Northwestern basically wrote a paper on it because there is an organic basis for that. So if you see a case like that, there’s, you know. There is a basis for it. They’re rare, but they do pop up. [5:57] Tom Crosley: Yeah. So I think there are three things that separate really great lawyers from good lawyers. One of them is being willing to learn the medicine inside and out. The second one is being willing to learn the client, and their experience inside and out. And a third one to me is having the guts to take the risk of saying no to a really good settlement offer and going to trial. [6:20] Scott Blair: Well, you know, in this case in December that you mentioned, that’s pretty much everything we had to do on that case. And it was a fascinating case because my client you know, he contacted me. He was a senior managing software engineer for Adobe here in Seattle. Incredibly smart guy and making a lot of money, close to half a million a year, and he was still working. You know, he went in to a local medical day surg

  8. Apr 2

    TBI Defined

    “The better you understand the definitions of mild TBI, the better equipped you are to read the records, evaluate the experts, and keep your case grounded in sound medicine.” – Tom Crosley Welcome to Winning The TBI Case, hosted by trial lawyer Tom Crosley. Listen as Tom provides practical, powerful guidance for litigating traumatic brain injury cases. This podcast is meant for litigation attorneys who are ready to explore the essentials of TBI cases to confidently represent clients who have suffered traumatic brain injuries. What’s In This Episode:In this episode, Tom Crosley explains how mild traumatic brain injury is defined using both the ACRM 1993 and updated 2023 frameworks. He breaks down the three primary pathways to diagnosing TBI and how those definitions show up in real cases. And finally, Tom provides the simplified jury presentation that keeps the focus on symptoms, causation, and long-term impact. Understand the Framework This is for trial lawyers who want a clearer, more practical understanding of how mild TBI is defined and how those definitions are used in real cases. Tom Crosley breaks down the definitions that form the backbone of every brain injury case. He explains the evolution from the 1993 American Congress of Rehabilitation Medicine (ACRM) definition to the comprehensive 2023 update that created three distinct pathways to diagnosis: Clinical signs Symptoms with objective findings Abnormal imaging (NOTE: most mild TBIs will not appear on routine scans) If you’ve ever found yourself caught in a word play battle with the defense over terminology instead of focusing on the injury itself, this episode will help you reframe your approach. Winning the TBI Case — Episode 18: TBI Defined Crosley Law | Aired: April 2, 2026 | Runtime: 12:28 | Speakers: Narrator, Tom Crosley [0:00] Tom Crosley: The case is not about the label. The case is about what the symptoms are and were those symptoms caused by the crash or the event, and what does the future hold? [0:09] Narrator: TBI cases can feel like navigating uncharted territory. Your client’s injury is real, but proving it, that’s where the real challenge begins. If you’ve ever felt like you’re missing crucial pieces of the puzzle, you’re in the right place. Welcome to Winning the TBI Case, where Tom Crosley shares the insights he’s gained from over 60 injury trials. Not just the victories, but the lessons learned along the way that make all the difference. This is practical wisdom from someone who’s been in your shoes and found a path forward. Winning the TBI Case, strategy, science, and storytelling. Let’s join Tom as he breaks down the fundamental challenges of representing clients with invisible injuries. [1:00] Tom Crosley: Welcome back to Winning the TBI Case. I’m Tom Crosley, and today I want to talk about how mild traumatic brain injury gets defined, and this can become clunky in a hurry, and I don’t want it to turn into a word game instead of a useful discussion, so I’m gonna try to keep this simple and practical. Here’s the main point. Definitions matter, but they are not the whole case. A case does not rise or fall just because one expert wants to call it a mild TBI and another wants to call it something else. At the end of the day, the real questions are still the same. What happened in the traumatic event? What symptoms and impairments followed to your client as a result of that? Were those problems caused by the event? That’s where the case lives. How do these problems affect that person going forward in life? What does the future hold for this person? It’s not what label we attach to the injury. It was the injury caused by the event. So if a person develops headaches, dizziness, cognitive problems, balance trouble, light sensitivity, fatigue, irritability, an inability to function the way they used to function, those are always going to be real problems regardless of whether a defense expert wants to claim that it’s not a mild TBI. [2:21] Tom Crosley: So why then do definitions matter? They matter for two reasons. First, the better you understand the definitions of mild TBI, the better equipped you are to read the records, evaluate the experts, and keep your case grounded in sound medicine. The better able you are to avoid getting sidetracked by defense wordplay and semantic games. Second, medical literature is built on definitions. Researchers define who counts as a mild TBI and who does not, and then they study recovery, prognosis, treatment, long-term outcomes based on that defined group. So if you don’t understand the definition that they’re using, you probably don’t fully understand the literature either. So before I go further, let me say one quick word about the American Congress of Rehabilitation Medicine, the ACRM, because we’re studying and relying upon the ACRM definitions here. The ACRM is a major interdisciplinary rehab organization focused on research and evidence-based clinical practice. Its brain injury work has long been considered mainstream for over three decades. When the ACRM publishes something on TBI, lawyers should understand that this is important and widely respected. [3:43] Tom Crosley: It’s not some fringe view. So let’s talk about the 1993 ACRM definition of mild TBI, which for decades was the classic definition of mild TBI. It said that mild traumatic brain injury is a traumatically induced disruption of brain function shown by one of four things. Loss of consciousness, anywhere from zero minutes all the way up to 30 minutes. Beyond 30, it becomes moderate. Loss of memory around the event, so amnesia, as long as the amnesia resolves within 24 hours. If you have amnesia for more than a day after the event, they’re calling that moderate also. A fourth thing that will fit is focal neurologic deficits. It just means some kinda localized neurologic abnormality. Examples would include weakness or numbness on one side, facial droop, slurred speech, abnormal pupillary response, a visual field cut, impaired coordination in an arm or a leg. Those are pretty unusual, at least in my handling of these cases when I’m looking at medical records and we tend to see altered consciousness. Even if the person is not unconscious, we see altered mental status, dazed, confused, et cetera. Rarely do I see a documentation of a focal neurologic deficit, but it’s important to know what that means. [5:02] Tom Crosley: So the 1993 definition mattered because it gave medicine kind of a common agreement point. The problem is, over time, that got messy. Different specialties started using different approaches. Sports medicine came up with its own definition. Emergency medicine came up with another. The American Academy of Neurology came up with a different one. The neurosurgeons came up with a different one. So the ACRM got together leading up to 2023 and said, “Hey, we need to fix this and have one universal definition that we can all kinda rely on.” It was an effort to bring more order and consistency to the diagnosis of mild TBI. You probably ought to read it. It’s six criteria. It’s three different pathways, but it’s really easy to get lost there. So I try to boil it down, and if I’m gonna teach it to a jury, I’m gonna try to boil it down as basically as possible. That’s what I’m gonna try to do for you in this episode. I’ll leave it to you to let me know whether I succeeded or not. But here’s how I boil it down. Under the 2023 framework, there first has to be a plausible mechanism of injury, some kind of event capable of transmitting force to the brain. It could be a blow to the head. It could be the head striking an object. It could be acceleration, deceleration from a crash. [6:19] Tom Crosley: It could be a blast wave concussion type force. But once you have the plausible mechanism, there are basically three ways to get to the diagnosis. The first way is some obvious clinical signs. It’s the easiest one to understand. You have the injury event, and then you have obvious clinical signs of acute brain dysfunction. This route feels similar to the old 1993 definition. The second way of three that we get there without obvious clinical signs, we get there with symptoms plus objective support. So not every legitimate mild TBI comes with a nice clean witness account or a perfect ER note saying that the patient was definitely confused and repetitive at the scene. Real cases are often messier than that. Sometimes the person has the classic early symptoms, headache, dizziness, nausea, light sensitivity, brain fog, trouble concentrating, irritability. And sometimes those symptoms are backed up by objective findings on examination, such as abnormal balance, some kinda abnormal oculomotor testing, some kind of vestibular issue, an abnormal cognitive screen. So if you have some of those symptoms, two or more, and you have some kind of objective medical screen, then that is how you get there. [7:38] Tom Crosley: The third way you get there is abnormal structural imaging. That means a CT scan usually done in the ER, which as we know in these cases is most often normal. The other way we get there is a structural MRI that shows some kinda intracranial abnormality that’s related to trauma. That’s the imaging route. So let me be very clear here. Positive imaging is not required to diagnose a mild TBI. It has never been. Most mild TBIs do not show up on routine CT or MRI, but when they do show up on CT or structural MRI, that supports the diagnosis directly. And a lot of times, depending on what the abnormality is, it may move it beyond the mild realm into the moderate realm. I’m gonna leave advanced neuroimaging for another episode and keep today’s focus on the core diagnostic framework for the 2023 ACRM definition. That’s the simplified upd

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About

“Winning the TBI Case” with Tom Crosley is a podcast created exclusively for plaintiff attorneys handling traumatic brain injury (TBI) cases. Each week, veteran trial attorney Tom Crosley shares insights from over 15 years of brain injury litigation and 60+ trials—covering not just what worked, but why. Episodes dive into emerging trends, cutting-edge neuroscience, recent verdicts, and real courtroom strategies you can use. Get practical tips, expert interviews, and real-world analysis to help you win your next TBI case. New episodes drop every Tuesday, so you can make TBI Tuesday’s with Tom a regular part of your commute to the office.

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  • Creator
    Tom Crosley
  • Years Active
    2025 - 2026
  • Episodes
    26
  • Rating
    Clean
  • Copyright
    ©2026 Winning The TBI Case, Tom Crosley, All Rights Reserved
  • Show Website
    Winning The TBI Case

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