How Are Concussion Claims Documented

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Concussions, even those initially deemed ‘mild,’ can have a significant impact on a person’s life. They’re a type of traumatic brain injury (TBI) caused by a bump, blow, or jolt to the head. Because symptoms are often subjective and don’t appear immediately, establishing a clear connection to the accident is paramount. The insurance adjuster will be looking for gaps in medical records, inconsistencies in your reported symptoms, and any pre-existing conditions that could be blamed for your issues.

Documentation begins immediately after the accident. If you’re able, make notes of everything you’re feeling, even if it seems minor. This includes physical symptoms like headaches, nausea, or vision changes, as well as cognitive symptoms such as confusion, memory problems, or difficulty concentrating. Share these notes with your medical providers.

I’ve been practicing personal injury law in San Diego for over 13 years, and I’ve seen firsthand how insurance companies operate. Trained by a former insurance defense attorney, I intimately understand how they evaluate, devalue, and deny claims. They are experts at finding reasons to minimize your recovery, and a lack of solid documentation is their greatest weapon. They want to portray the injury as less severe than it is, or unrelated to the collision.

What types of medical records are important for a concussion claim?

A comprehensive medical record is essential. This includes the emergency room report from the day of the accident, documenting any initial assessment or complaints. Follow-up appointments with your primary care physician, neurologists, and any specialists you see (like physical therapists or neuropsychologists) are critical. Detailed notes from each visit, outlining your symptoms, treatment plan, and progress, are incredibly valuable.

Imaging scans, such as CT scans or MRIs, can help rule out more serious brain injuries, even if the initial results are normal. Neurological testing, like cognitive assessments or balance tests, can provide objective evidence of your impairment. Keep meticulous records of any medication prescribed, therapy sessions attended, and missed work or school due to your concussion.

Insurance adjusters will scrutinize any delays in seeking medical treatment, so it’s important to seek care as soon as possible after the accident. They’ll also want to see consistency in your symptoms and complaints—if you tell one doctor you’re feeling fine but another doctor you’re experiencing severe headaches, that raises red flags.

What if my concussion symptoms don’t appear right away?

Delayed onset of symptoms is common with concussions. It’s not unusual for symptoms to develop hours or even days after the initial impact. It’s vital to continue monitoring yourself and report any new or worsening symptoms to your doctor, even if it’s been some time since the accident. Document the date of onset of each symptom.

Clearly communicating this delayed symptom presentation to your doctor is crucial. They should document this in your medical records, explaining that the symptoms are consistent with a concussion caused by the accident, even if they didn’t appear immediately. Your doctor may recommend further testing or a longer course of treatment.

The insurance company might try to argue that your symptoms are unrelated to the accident if you didn’t seek treatment right away. Having detailed medical records outlining the delayed onset of symptoms, along with your consistent complaints, will help counter this argument.

How can I best document my day-to-day struggles with a concussion?

Keep a detailed symptom journal. This doesn’t need to be a formal medical document, but it should be a consistent record of how you’re feeling each day. Include specific details, such as the severity of your headaches, any difficulty you’re experiencing with memory or concentration, and how your symptoms are impacting your ability to perform daily tasks.

Be honest and thorough in your documentation. Don’t minimize your symptoms or try to downplay the impact of your concussion. The more detailed your journal, the better. It’s also helpful to ask family members or friends to document any observations they’ve made about your condition.

Photographs or videos can also be helpful. If you’re experiencing dizziness or balance problems, a video can demonstrate the issues. If you’re having difficulty with cognitive tasks, such as reading or writing, photos of your work can show the challenges you’re facing.

What role do expert witnesses play in concussion claims?

In some cases, it may be necessary to involve an expert witness, such as a neurologist or neuropsychologist, to provide testimony regarding your concussion and its long-term effects. An expert witness can review your medical records, assess your symptoms, and provide an opinion on whether your concussion was caused by the accident and the extent of your injuries.

Their testimony can be particularly valuable if the insurance company is challenging the severity of your injuries or denying your claim. The expert witness can explain the complexities of concussions, the potential long-term consequences, and the standard of care for treating these injuries. This independent medical examination is often required in cases of serious injury.

The cost of hiring an expert witness can be significant, but it may be necessary to build a strong case and maximize your recovery. It is important to discuss this with your attorney to determine if an expert witness is appropriate for your case.

Can I recover lost wages if I’m unable to work due to a concussion?

Yes, you can recover lost wages if you’re unable to work due to a concussion. You’ll need to provide documentation of your earnings, such as pay stubs or tax returns, as well as a letter from your doctor stating that you’re unable to work due to your concussion. The letter should also specify the duration of your disability.

If you’re self-employed, you’ll need to provide documentation of your self-employment income, such as tax returns or business records. It’s also important to document any lost business opportunities or projects due to your concussion. Be sure to include any out-of-pocket expenses related to your lost income, such as the cost of hiring temporary help.

Insurance companies may try to challenge your lost wage claim, so it’s important to have thorough documentation and be prepared to provide additional evidence if necessary.