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Brain injury series: what is an immediate needs assessment?

By Mark Hollinghurst

Published In: Brain and Spinal Injury

Many of our clients instruct us after experiencing serious and life changing injuries. One of the first things we will do is organise an Immediate Needs Assessment (INA). This will help our specialist legal team to better understand the range of problems and issues you face, and how we can help you with those. Our team understand that early access to skilled rehabilitation professionals, treatment and equipment can be instrumental to recovery.

Doctors looking at a head x-ray

If you are thinking about making a brain injury claim, either for yourself or on behalf of a family member, you may want more information on the process before you begin. In this stage-by-stage guide, I’ll explain each step and what to expect during your claim.

What is an INA?

An INA is a full assessment of your clinical, therapeutic and practical needs. These are usually conducted by a “case manager”. For those outside brain injury, this is a rather unfamiliar term and role. A case manager is a vital person supporting the brain injured individual to maximise their recovery.

This assessment will usually take place within 21 days of the appointment of your case manager. They will make a number of recommendations, which can include: what medical treatment you need; what therapy you need; whether you need any adaptations at home; what assistance and support may be required, equipment suggestions; and return to work.

Case manager background

A case manager will usually come from a therapeutic or nursing background. Typically, you may find that they started out as occupational therapists, physiotherapists or nurses. Some come from social work backgrounds. Choosing the right case manager is vital to ensuring you get the most out of an INA. To you, as the brain injured individual, this process and experience is likely to be completely alien to you. It can be hard to understand the priority of competing problems you are experiencing and how they can be combatted through a multi-disciplinary approach. The best case managers will ask the probing questions at the INA, bringing out relevant details, allowing them to prepare the most informed INA report setting out areas to explore with you.

 Often your brain injury solicitors will recommend case managers who they feel can provide the best service possible, but it’s important that you feel you can work with the individual, as it is often a long-term relationship. Therefore, you should feel able to ask for initial, no obligation chats with a potential case manager before an INA. This often leads to a better working relationship in the long run. The British Association of Brain Injury Case Managers (BABICM) offer a directory of recognised brain injury case managers you can research at

Funding an INA

The INA is often funded by way of an interim payment released from the Defendant’s Insurer to your solicitor, or the Defendant’s Insurer will pay for the INA directly.

If the INA is being paid for directly by the Defendant’s Insurer, that is likely to be under the framework of the Rehabilitation Code or the Serious Injury Guide. These can often be helpful where there is collaborative working between your solicitor and the Defendant’s Insurer. It can provide for prompt action and funding for recommendations on therapy and support.

 Once the INA has taken place, a report will then be produced. This report is shared with your solicitor and the defendant’s insurer. If the case manager has not been instructed jointly under the Rehabilitation Code/Serious Injury Guide, then your solicitor will disclose this report to them and request an interim payment to fund the recommendations arising from that report. Your chosen case manager will then continue to work with you and the team of therapists recommended and ensure the management and implementation of the therapeutic programme stays aligned to your goals and objectives. Support workers may also be recommended.

 The INA is a crucial first step in understanding your difficulties and how best to combat them. However, it’s important to understand that plans can change, and the recommendations will be flexible according to your changing needs. You are after all, an individual person who has sustained serious trauma. You are re-discovering yourself after the most shocking of events in your life. You should feel empowered to speak with the case manager and work with them to achieve the best possible results that you can.

 If you’d like more information about brain injury case managers generally and the work that they do, then please visit their information page at

 To speak to us about making a brain injury claim. Contact 01302 320621 or email


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Mark qualified as a solicitor in 1991.  He is Head of Switalskis’ Brain and Spinal Injury team and Joint Head of the firm’s Personal Injury department.  Mark is also a member of Switalskis' Management Board.

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