It can be challenging to rate patients with head trauma and multiple neurological injuries. Section 13.2, Criteria for Rating Impairment Due to Central Nervous System Disorders (5th ed, 308), outlines the process to rate impairment due to head trauma. The principles are illustrated in the following case involving a closed head injury.

Mr. B is a 57-year-old, right-handed, technical school educated, married father, and security guard who complains of problems including headache, decreased sensation on the left cheek, loss of sense of smell, and problems with memory among other symptoms. Mr. B attributes his symptoms to the effects of an injury, which occurred on the job one year ago.

At the time of that injury, Mr. B was assaulted on the job. Following the assault, he was transported by ambulance to the hospital. In the emergency room, his...

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