Citation

Aghababian V, Berland Benhaim C, Bartoli C, Léonetti G. Encephale (1974) 2010; 36(2): 139-146.

Vernacular Title

Implication du rapport Dintilhac dans l'expertise neuropsychologique.

Affiliation

EA 3273, UFR de psychologie, centre de recherche en psychologie de la connaissance, du langage et des émotions (PsyCLE), Aix-Marseille université, 29, avenue Robert-Schuman, 13621 Aix-en-Provence, France; CHU de la Timone, 264, rue Saint-Pierre, 13385 Marseille, France.

Copyright

(Copyright © 2010, Masson Editeur)

DOI

10.1016/j.encep.2009.06.002

PMID

20434631

Abstract

BACKGROUND: When preparing neuropsychological expert reports, the neuropsychologist is asked to make a precise assessment of the victims' cognitive dysfunction, generally after traumatic head injury. The expert is usually required to assess the nature of the neuropsychological deficits, their correlation with any brain lesions and their imputability to the accident or crime in question, to estimate a possible date of stabilisation and to evaluate the heads of damage. The basic principle of compensation for personal injury is to consider the circumstances in which the victim would have been if the prejudicial event (for example, the accident) had not occurred and to assess, on the basis of these various heads of damage, compensation for the injury suffered. While it is not the neuropsychologist's role to evaluate the compensation as such, he or she has however to specify which aspects of cognitive function are deficient and what impact this dysfunction has on a personal and occupational level. Until recently, compensation for personal injury, and notably for cognitive deficits, was assessed with reference to nine principal heads of damage, in particular the conventional concepts of total temporary disability (incapacité temporaire totale ITT.), defined as the period during which the victim was temporarily unable to carry out their usual occupational and personal activities, and partial permanent disability (incapacité partielle permanente IPP.), defined as a percentage and corresponding to the reduction, after stabilisation, in the victim's functional capacity - that is, their physical and psychological potential - here again from an occupational and personal viewpoint. However, concretely, the emphasis had shifted to take into account only the pecuniary aspects of injury relating to the domain of "having", that is the loss of income due to cessation of work, while the non-pecuniary aspects relating to the domain of "being" were often ignored. NEW CLASSIFICATION: The Dintilhac report has established a new classification of heads of physical damage which abandons these two ambiguous concepts of ITT and IPP. Damage now includes three categories: pecuniary and non-pecuniary; temporary and permanent and damage to direct and indirect victims. We define the new heads of damage to direct victims, illustrate them with examples from neuropsychological expert reports, compare the old and the new classifications and discuss the implications of the Dintilhac report for expert assessment. The report appears to remove the ambiguities previously mentioned, since ITT has been replaced by two new heads of damage which are clearly defined as pecuniary and non-pecuniary: "loss of present occupational income" (pertes de gains professionnels actuels PGPA.) and "temporary functional deficiency" (déficit fonctionnel temporaire DFT.), respectively. Similarly, IPP is replaced by two new heads of damage, which are also clearly defined as pecuniary and non-pecuniary and are the poststabilisation equivalents of PGDA and DFT: these are "loss of future earnings" (pertes de gains professionnels futurs PGPF.) and "permanent functional deficiency" (déficit fonctionnel permanent DFP.). Concerning the other heads of damage, the amendments introduced by the new classification do not basically modify the earlier concepts but are nevertheless more precise in certain respects. The "pretium doloris", or "price of pain", is replaced by "suffering sustained" (souffrances endurées SE.) with little fundamental change. The same is true of "loss of amenity" (préjudice d'agrément PA.). The term of "aesthetic impairment" (préjudice esthétique PE.) also remains the same, but whereas it previously related only to permanent impairment, it now includes temporary impairment, before stabilisation. What was formerly termed "loss of sexual function" now consists of "loss of sexual function" (préjudice sexuel PS.) as well as "loss of the prospect of founding a family" (préjudice d'établissement PE.), allowing a finer distinction to be made between the damages sustained. The former "third party" (tierce personne) is now covered under the headings of "assistance by a third party" (assistance par tierce personne ATP.), "expenses of accommodation conversion" (frais de logement adapté FLA.) and "expenses of vehicle conversion" (frais de véhicule adapté FVA.), which here again provides greater precision in the heads of compensation. Lastly, what was previously known as "loss of opportunity" (perte de chance) is divided into three different categories: "loss of education, whether at school, university or in training" (préjudice scolaire, universitaire ou de formation PSU.), "loss of future occupational earnings" (perte de gains professionnels futurs PGPF.) and in part the "occupational impact" (incidence professionnelle IP.). CONCLUSION: In summary, these various heads of damage concerning direct victims that are proposed by the Dintilhac report result in a more detailed evaluation of compensation for personal injury. Assessment of a certain number of heads of damage is an integral part of the preparation of a neuropsychological expert report and the fact that these heads of damage are now better defined makes the expert's task easier. As the neuropsychologist, generally called upon to give an expert opinion, now has better knowledge of this new classification, he or she will be able to give clearer and fuller answers to the questions raised and so comply with the principle of civil law relating to compensation for personal injury: "compensate the injury, all the injury, but nothing except the injury".

Language: fr