The claimant sought a determination that he was catastrophically impaired after a motorcycle accident in July 2018. Under Criterion 4 there is a two-prong test which must be satisfied. The parties agreed that the first prong of the test had been met as there was sufficient diagnostic evidence of brain trauma. Looking at the second prong of the test, Adjudicator Hines outlined the purpose of the GOS-E and provided guidance regarding its application, including the necessity of clinical judgement to distinguish between the impact of brain injury on function versus other impairments. The LAT ultimately preferred the evidence of the claimant’s experts and concluded that he had sustained a lower moderate disability one-year after the accident, sufficient for a catastrophic designation under Criterion 4.