I agree with Mark that you should have a neuro-psych by a competent neuro-psychologist. I also agree that folks with a very high premorbid IQ get shafted.

Mark is also right that a lot of doctors are put out when they have to deal with brain damaged patients who are still smarter than they are. My GP dismissed the findings in my neuro-psych about my difficulties organizing myself and spotting errors by telling me I should "stop whining" because I'm still plenty smart enough. I then offered to do his taxes for free. Funnily enough, he didn't take me up on the offer.

I was lucky to have one of the best neuro-psychologists in the country. He was able to put my test results in context. I still test above average on most things - but that's a staggering drop considering my pre-morbid IQ. Frankly, "average" is a pretty sad level of function and to rate as "disabled" you pretty much have to be in a vegitative state.

I am also blessed to have a cognitive therapist who isn't intimidated by the fact that I still process a lot of stuff faster than she does. She knows what's important is how I'm doing the tasks, the unevenness of my performance from task to task and the fact that when I do make mistakes, I can't see them. What job can you do where you're oblivious to glaring errors? (I mean, other than politics.)

The thing about brain injuries, is that they can be pretty idiocyncratic. I have a spiral injury (all areas of the brain damaged), but my function varies widely from lobe to lobe. I process visual information pretty well, but auditory is difficult. The high level cognitive functions in my frontal lobe are a disaster. The neuro-psych will give you a clearer picture of what your brain in actually doing so you can make appropriate career choices.

The neuro-psych is also important because, sadly, we are often not the best judges of our abilities. Many of us have lost the insight to appreciate the depth and impact of our cognitive deficits. As I said, I can't see my mistakes. For example, I could be numbering a page and jump from 102 to 210 and never see it unless someone pointed it out. Before my neuro-psych, I entertained thoughts of starting my own bookkeeping service. Oops!

Contrary to being whiners, over time we get used to our disabilities and tend to under-estimate them. In my case, I knew, because I had trouble with buttons and stuff, that I had some motor skill issues in my hands. I was shocked when the neuro-psych rated my function in the lowest 2%.

Over-estimating myself was a running theme in my neuro-psych assessment. I just had no idea how badly I was doing. During the follow up interview, I kept looking over to my husband asking, "Do I really do that?" And he'd just nod his head with tears running down his face.

The neuro-psychologist explained that the brain damage often makes it impossible for us to know how we've changed. And we're not just missing the little things. There have been cases of TBI patients who can't register that they've lost sight in one eye because their brain is too damaged to process that information.

The point of this rambling missive is that you may not be in the best position to access your strengths and weaknesses. You need competent neuro-psychologists and occupational neurologists to test you and help you make realistic decisions.

Good Luck