James T. Snyder Law, PLLC
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How is loss of consciousness after a personal injury accident measured to determine pain and suffering damages?

Photograph:  Abstract photo showing image of brain neuron connections, like a web.

In a brain injury setting following a car crash or motorcycle accident, construction injury, slip and fall or medical malpractice incident, loss of consciousness -- temporary or permanent -- raises the question of whether and to what extent the injured party is conscious “at some level” of his or her pain and suffering, sufficient to establish general pain and suffering damages, for example, at New York State Pattern Jury Instructions § 2:280. 

In certain circumstances, especially with head injuries, this can be a difficult problem of proof, as lay people (jurors) understand unconsciousness idiomatically as being “totally out of it.”  However, medical science and literature does not share that “one-size-fits-all” definition, and it is incumbent upon the lawyer for the severely injured plaintiff to educate the jury that there are different levels of consciousness that can be quantitatively measured by medical professionals, and that the generic term “loss of consciousness” does not mean complete loss of awareness by the injured party.

One standard, objective means of measurement of consciousness is the Glasgow Coma Scale; find it at:


The Glasgow Coma Scale measures multiple, objective levels of impairment of consciousness.  It is routinely measured where a patient is found not conscious, and it measures up to 18 different criteria on zero to 6 scale.  The higher the scale score, the greater the level of underlying consciousness is -- which may be critical to a pain and suffering analysis in a brain injury case, especially when determining what happened at the accident scene. 

Although a gruesome task, emergency personnel are required to immediately ascertain at the scene if the injured person is dead or alive, and if alive, what their level of consciousness is.  Critical treatment decisions flow immediately from such an analysis.  It is therefore imperative to review emergency and ambulance records, hospital emergency room records, etc., to find the plaintiff (or plaintiff’s decedent’s) Glasgow Coma Score, or “GCS.”

In addition to the Glasgow Coma Scale, there is another objective test utilized by medical professionals to measure level of consciousness, the Rancho Los Amigos Scale (“RLAS”) or Rancho Los Amigos Levels of Cognitive Functioning Scale (“LOCF”).  This test, often used in conjunction with the Glasgow Coma Scale, assesses the longer-term cognition of people who have sustained and survived a closed head and/or traumatic brain injury, and, as set forth in literature from Rancho Los Amigos National Rehabilitation Center in California, “the eight levels describe the patterns or stages of recovery typically seen after a brain injury.”

A description of this “Rancho Scale” can be found at:


If you, a friend or a loved one has suffered a brain injury as a result of the negligence of another person or entity, give me a call or send me an email to discuss.  Your contact with me is always free, prompt and personal. 

James Snyder