Traumatic Brain Injury (TBI)

Yes. Concussion and mild TBI can occur from the inertial forces of rapid acceleration-deceleration without any direct head impact. When the head is rapidly accelerated and then decelerated — as happens in a rear-end collision — the brain continues to move inside the skull after the skull stops moving, causing stretching and shearing of brain tissue (diffuse axonal injury). This mechanism is well-documented in the TBI literature and is why MAIC evaluates all patients for TBI symptoms regardless of whether a head strike was reported.

Standard brain MRI and CT scans are designed to detect structural abnormalities like hemorrhage, contusion, and edema — findings that occur in moderate to severe TBI. In mild TBI (concussion), the injury is at the microscopic level — axonal shearing and neuroinflammation that are below the resolution of standard imaging. This is why the diagnosis of concussion is clinical, not radiological. Advanced techniques like susceptibility-weighted imaging (SWI) can detect microhemorrhages, and diffusion tensor imaging (DTI) can show white matter tract disruption — findings that correlate with TBI but require specialized acquisition and interpretation.

Post-concussion syndrome (PCS) is the persistence of concussion-related symptoms beyond the normal recovery window — typically defined as more than 4 weeks in adults. Common symptoms include headache, difficulty concentrating, memory problems, fatigue, sleep disturbance, irritability, anxiety, depression, and sensitivity to light and noise. In some patients, PCS symptoms persist for months to years. The chronicity and severity of PCS symptoms directly affects the damages calculation in a personal injury claim, making thorough neurological documentation of symptom onset, severity, and functional impact essential.

Yes. MAIC accepts New York State No-Fault insurance and No-Fault for TBI and post-concussion syndrome evaluation and treatment including neurological examination, cognitive testing, MRI imaging, and neuropsychological consultation. All prior authorizations are managed by our PI coordination team. TBI evaluation following motor vehicle accidents is specifically covered under NYS No-Fault regardless of fault determination.

MAIC's TBI documentation is designed to establish four key elements: (1) the mechanism of injury and its capacity to produce TBI based on established biomechanical thresholds; (2) the presence and severity of acute TBI based on LOC, alteration of consciousness, amnesia, and acute symptom complex; (3) the progression and persistence of post-concussion symptoms documented through structured assessment tools; and (4) the functional impact on work, daily activities, and quality of life. Our neurological causation narrative addresses each element and is written to withstand challenge from defense medical examiners.