Approximating Pre-Injury Cognitive Capacity

//Approximating Pre-Injury Cognitive Capacity

Approximating Pre-Injury Cognitive Capacity

I have just completed a forensic case in which one of the key issues was the brain-injured client’s pre-injury cognitive capacity. This is always a difficult issue to pin down and is usually best handled either with grades from school, academic standardized tests, or pre-injury occupational performance.

With the first two, it is straightforward to use either grades or standardized tests as a baseline because normative comparisons are available for the popular intelligence or achievement tests that we can administer to the client.

However, my client was educated overseas and did not complete secondary school in his home country. He came to the United States in his early 20s and was injured at about age 40. In the interval, he worked as an athletic trainer on an entrepreneurial basis. That is, he did not go to college or graduate school and obtain the available certifications that have an academic basis, but was very successful in selling his services to sophisticated clients in the entertainment industry and the professional sports industry. He was so well-recognized that he was earning about $200,000 per year at the time that he got hurt, approximately 3 times the annual earnings of the 90th percentile athletic trainer, based on data from O*NET.

Using this information, I was able to use the O*NET Cognitive Abilities data that are the basis of the Cognitive Abilities Profile (CAP) that previously has been distributed to Clinical Research Consortium participants. Click on the thumbnail below to view the CAP for athletic trainers:

Cognitive Ability Profile

With this profile, I was able to successfully argue that my client’s pre-injury cognitive abilities approximated those of athletic trainers, based on the assumption that he had been successfully competing for employment as an athletic trainer.

Using the standardized data from this profile (the Z-scores are directly convertible to standard deviations, which are a close approximation of percentile rankings) it was easy to argue that his pre-injury cognitive profile ranged from high-average to above-average for the seven out of 10 cognitive abilities that are in that range in the profile. Comparison of his intellectual function data from the neuropsychologist and his occupational performance data from my testing allowed me to successfully argue that he would be unable to return to work as an athletic trainer.

This is a pretty typical application of the CAP, and is especially important and useful when we don’t have trustworthy pre-injury academic performance data. In some cases the academic performance data are quite old and were obviously eclipsed by subsequent occupational performance, while in other cases (like the present) the academic performance data are just unavailable.

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