PTSD After a Car Accident: How a Psychological Injury Is Claimed

Post-traumatic stress disorder is a recognized psychiatric condition that can follow any event involving actual or threatened death or serious injury, and motor vehicle crashes are among its most common causes. The symptoms fall into four groups: re-experiencing the crash through intrusive memories, nightmares or flashbacks; avoiding reminders, which for many people means avoiding driving or riding; negative changes in mood and thinking; and heightened arousal, meaning sleep problems, irritability, being easily startled and difficulty concentrating.

A diagnosis requires that symptoms last more than a month and cause real impairment. Many people have intense symptoms in the first weeks that fade; that is acute stress, not PTSD, and it is still compensable as pain and suffering for the period it lasted. PTSD is the diagnosis when the symptoms do not fade.

It is often missed because the physical injuries dominate the early treatment, because people do not mention nightmares to an orthopedic surgeon, and because many people assume that fear after a crash is normal and not a medical matter. It is normal for a few weeks. When it is still controlling someone's life at three months, it is an injury with a name, and it should be treated and documented as one.

The foundation is a diagnosis by a qualified mental health professional, a psychologist or psychiatrist, based on recognized diagnostic criteria. A primary care doctor's note that the patient reports anxiety is a starting point but not a diagnosis the insurer will value. The referral should happen as soon as symptoms are evident, and the referral itself, from the treating physician, is evidence that the symptoms were real enough to warrant it.

Treatment follows. Cognitive behavioral therapy, trauma-focused therapy and medication are the standard treatments, and the record of attending them, the clinician's progress notes, and any standardized symptom measures administered along the way are the evidence of severity and course. A claim for PTSD with two therapy sessions and no follow-up is weak; one with six months of documented treatment and a clinician's opinion on prognosis is strong.

The functional evidence completes it. A person who cannot drive loses independence, may lose a job that requires driving, pays for alternatives, and depends on others. A person who cannot sleep performs worse at work. These are documented through employer records, receipts, and the accounts of family members, and they turn an abstract diagnosis into losses a jury can see.

Suppose you were driving on a highway at night when a wrong-way driver struck your car head-on. You suffered a fractured sternum and a broken wrist, which healed over four months. But you could not drive afterward; attempts produced panic attacks, you had nightmares several times a week, and you began avoiding the highway entirely. Your doctor referred you to a psychologist at month three, who diagnosed PTSD and began weekly trauma-focused therapy.

By month ten, therapy had reduced the nightmares and you could drive short distances on surface streets, but not on highways, which added forty minutes to each commute. The psychologist's report described the diagnosis, the treatment, the measured improvement, and a prognosis of continued but incomplete recovery. Therapy costs were $6,800, and you had turned down a promotion that required regional travel.

The claim presented the physical injuries, the therapy costs as economic damages, the lost promotion with your employer's confirmation, and a pain and suffering component that treated the PTSD as a lasting injury on the same footing as the fractures. The insurer's first offer had valued the psychological component at almost nothing, citing the absence of a diagnosis in the first two months; the psychologist's report and the therapy record moved it substantially. All figures are hypothetical.

Psychological injuries are treated and documented by the same steps, and the steps are easy to skip when the physical injuries seem more urgent.

• Tell your treating doctor about nightmares, panic, avoidance, sleep problems or fear of driving at every visit, so they appear in the medical record early.
• Ask for a referral to a psychologist or psychiatrist if symptoms last more than a few weeks; do not wait for them to resolve on their own.
• Attend therapy consistently and follow the treatment plan; gaps are read as recovery.
• Keep a brief daily log of sleep, nightmares, panic episodes and what you avoided, from the first week.
• Document the practical effects: rides you had to arrange, work you missed or declined, activities you stopped.
• Disclose any prior mental health history to the clinician; a documented change from your baseline is the claim, and hidden history found later damages it.
• Ask the clinician, when treatment is well advanced, for a written opinion on diagnosis, causation and prognosis.

Every state allows recovery for psychological harm that accompanies a physical injury from the crash, as part of pain and suffering. The variation is in claims where there is no physical injury: a person who was unhurt but witnessed a death, or who was in a terrifying near-miss. Some states allow emotional distress claims only with a physical impact, some require that the person was in the zone of danger, and some allow bystander claims for witnessing injury to a close relative. These rules are state-specific and an attorney should be consulted on any claim with no physical injury.

No-fault states, including Florida, Michigan, New York and New Jersey, pay for psychological treatment under personal injury protection in the same way as physical treatment, up to the limit, and a pain and suffering claim against the at-fault driver requires meeting the state's injury threshold, which in most of them is defined in terms of physical injury. PTSD alone may not meet the threshold; PTSD alongside a qualifying physical injury is included in the claim.

Damage caps on non-economic damages, where a state has them, apply to the psychological component. Comparative negligence applies as in any crash, and the contributory negligence states, Alabama, Maryland, North Carolina and Virginia, can bar the whole claim for any fault. The deadline is the state's injury statute, one year in Tennessee and Kentucky, two in Texas, California, Florida and Georgia, three in New York and North Carolina, and it runs from the crash, not from the diagnosis.

The first is that the symptoms are subjective. A diagnosis by a qualified clinician using recognized criteria, standardized symptom measures, and a treatment record are objective evidence of a subjective condition, and courts treat them as such. The absence of a scan does not make PTSD less real than a disc injury, and the clinician's report is the equivalent of the MRI.

The second is that the condition is pre-existing. Many people have some history of anxiety or depression, and the insurer will find it. The answer is the documented change: a person who managed mild anxiety and worked full time before the crash and cannot drive or sleep after it has a new injury or an aggravated one, and both are compensable.

The third is that the person has not sought treatment, so the condition cannot be serious. This is the argument that actually works, because it is often true that treatment was never sought. The remedy is to seek it. Treatment is what makes the claim, and more importantly, it is what makes recovery likely.

A psychological injury claim is often the undervalued part of a crash claim, because it was never diagnosed, never treated, or never presented as the lasting injury it is. The questions to answer early are whether a qualified clinician has made the diagnosis, whether treatment is documented, and whether the functional effects on driving and work have been recorded. 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 facts before anyone can say what the claim is worth. If a crash has left you unable to drive, sleep or function as you did before, you can request a free claim review.

• Car Accident Claims in the United States: The Complete Guide
• Truck Accident Claims: Liability, Federal Rules and Compensation
• Wrongful Death Claims: Who Can File, Deadlines and Damages
• Airbag Did Not Deploy in a Crash: Can You Sue, and Whom?
• At Fault in a Car Accident? Comparative Negligence Explained
• What Is the Average Car Accident Settlement? What Sets the Value
• Back and Neck Injury Settlement After a Car Accident: Factors
• Bicycle Accident Claim: Hit by a Car While Riding
• Broken Bone Car Accident Settlement: What Drives the Value

Need local rules? Choose your state from the injury law guides hub or read the statute of limitations by state.