Concussion Car Accident Settlement: Proving an Injury Scans Miss

A concussion is a brain injury caused by a blow or a sudden acceleration that makes the brain move inside the skull. In a car crash, it happens when the head strikes the window, steering wheel or headrest, or simply from the whipping motion of a hard impact with no contact at all. The injury is to the function of brain cells, not to the structure the scans show, so CT and MRI are usually normal. Those scans are done to rule out bleeding, not to confirm a concussion.

Diagnosis is clinical. A doctor looks for symptoms such as headache, dizziness, nausea, confusion, sensitivity to light and noise, sleep disturbance, trouble concentrating, and memory gaps, and may use a standardized assessment. Loss of consciousness is not required; most concussions involve none. A brief period of feeling dazed, or not remembering the moments around the crash, is enough.

This is the central problem for the claim. The insurer has a normal scan and a list of symptoms you reported. The adjuster's argument writes itself. The response is a record that shows a doctor made the diagnosis promptly, the symptoms were consistent over time, and they affected your life in ways other people observed.

Most people recover from a concussion within two to four weeks. A claim for that kind of injury is real but modest, usually valued in a similar band to a significant whiplash: the emergency visit, follow-up, time off work, and a period of headaches and disruption. Insurers settle these claims regularly once the diagnosis is documented.

When symptoms persist beyond about three months, the diagnosis becomes post-concussion syndrome. Headaches, cognitive slowing, memory problems, mood changes, fatigue and sleep disruption that continue for months or longer are a different injury in the eyes of the law, with different proof requirements and a much wider range of value. The claim now depends on specialists: a neurologist, a concussion clinic, and frequently a neuropsychologist who administers formal testing.

Neuropsychological testing is a day-long battery that measures memory, attention, processing speed and executive function against normal ranges and includes validity measures that detect exaggeration. A report showing deficits that are consistent with the injury and the symptoms is the single piece of evidence that moves a post-concussion claim from a dispute about subjective complaints to a dispute about damages.

Suppose you were a passenger in a car hit on the driver's side at an intersection by a driver who ran a red light. Your head struck the window. At the emergency room that night you were confused, nauseated and could not recall the impact. A CT scan was normal and you were discharged with a diagnosis of concussion. You had headaches and trouble concentrating for five weeks, missed two weeks of work worth $3,000, and then recovered. Bills totaled $9,000.

That claim is documented well: a same-day diagnosis, a clear mechanism, a recovery period, and no prior history. The at-fault driver's insurer would value it on the bills, the lost wages, and a period of pain and disruption, and most such claims settle within months of recovery.

Now suppose the headaches and concentration problems did not resolve. At four months a neurologist diagnosed post-concussion syndrome. At six months, neuropsychological testing showed deficits in processing speed and working memory with valid effort. You returned to work but were moved to a lower-paid role, and your spouse described personality changes. This is no longer a $9,000-bills claim with a modest premium; it is a claim about ongoing impairment and lost earning capacity, valued on expert evidence, and the at-fault driver's $50,000 policy is very likely to be the ceiling, with your own underinsured motorist coverage as the next source. All figures are hypothetical.

Concussion claims are won in the first days and lost over the following months when the record goes quiet. The steps below are about making the record say what happened.

• Get examined the same day, at an emergency room or urgent care, and say exactly what you remember and do not remember about the impact.
• Report every symptom, including ones that feel minor or embarrassing: trouble finding words, irritability, feeling foggy, sensitivity to light.
• Follow the discharge instructions on rest and screen time, and keep the follow-up appointment even if you feel better.
• Keep a daily symptom log for the first month: headache severity, sleep, concentration, mood, and what you could not do.
• Ask a family member or colleague to write down what they observed, with dates; insurers give weight to observations from people who saw you before and after.
• If symptoms last past a few weeks, ask for a referral to a neurologist or concussion specialist, and ask whether neuropsychological testing is appropriate.
• Tell every provider about any prior concussions, migraines, or mental health history; the comparison between before and after is the claim.

In no-fault states, a concussion is often the injury that decides whether a lawsuit against the at-fault driver is possible at all. New York's serious injury threshold and Florida's permanent injury requirement are hard to meet with a concussion that resolved in a month, and much easier to meet with documented post-concussion syndrome. Michigan and New Jersey have similar thresholds. Personal injury protection pays the early medical bills in these states regardless.

Comparative negligence applies as in any crash, and a head injury claim with disputed fault is harder in the contributory negligence states, Alabama, Maryland, North Carolina and Virginia, where any fault can bar recovery. Some states cap non-economic damages in certain cases, which matters for a permanent cognitive injury where the non-economic loss is the bulk of the claim.

Deadlines run from the crash: one year in Tennessee and Kentucky, two in Texas, California, Florida and Georgia, three in New York and North Carolina. Post-concussion syndrome is often not diagnosed until months in, and neuropsychological testing comes later still, so a one-year state can require filing suit before the medical picture is complete.

The first defense is that the scans were normal. The answer is that scans do not diagnose concussions, and the treating doctor's note saying so, or the discharge paperwork describing concussion with a normal CT, is usually enough. The second is that symptoms are subjective. The answer is consistency across providers, observations from other people, and, for lasting symptoms, neuropsychological testing with valid effort measures.

The third is pre-existing conditions. Migraines, anxiety, depression, ADHD and prior concussions are common, and the insurer will find them. The answer is not to hide them but to show the change: a person who had occasional migraines and now has daily headaches, a person who managed anxiety and now cannot work in an open office. Aggravation of a prior condition is compensable everywhere.

The fourth is malingering, the suggestion that symptoms are exaggerated for money. Validity testing within neuropsychological assessment exists precisely to answer this, and a report that passes those measures is strong evidence. A log kept from the first week, before any claim was contemplated, also helps.

A concussion that resolved quickly, with a same-day diagnosis and a clear record, is a claim an insurer will usually settle fairly once treatment is complete. The claims that need an attorney are the ones where symptoms have persisted, where the insurer is relying on the normal scan, where the medical referrals needed to build the evidence have not happened, or where the policy limits are below what the injury is worth. Most personal injury attorneys work on contingency.

Ask Legal Matters is a free claim-review request service, not a law firm. Requests may be shared with independent attorneys and legal services partners who handle inquiries in your state, and an attorney must evaluate the medical facts before anyone can say what the claim is worth. If you were diagnosed with a concussion after a crash and symptoms have not gone away, you can request a free claim review.

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