What Is a Concussion Worth in a Workers’ Compensation Claim?

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A concussion is classified as a minor traumatic brain injury (TBI). It can cause a change in mental state that could result in losing consciousness. Anyone can suffer a concussion, whether as a result of a car accident or suddenly striking one’s head on a hard surface.

Concussions aren’t usually life-threatening, but they often require medical attention.

The effects from concussion can last for weeks or even months. The effects can include headaches, dizziness, and even brain injuries. If you have fallen at work and your physician diagnoses you with a concussion, you may need to rest for several months before you are able to return to work, which will mean you can't earn money.

However, in most states you are covered by workers’ compensation, which is a payment made to you by your employer’s insurer. It covers two thirds of the cost of your lost earnings and the cost of your medical treatment from the accident through to full recovery.

Symptoms and Frequency of Concussions

When you fall and strike your head on a sharp object, you will need to be rushed to the hospital in case it turns out to be more serious than a concussion.

The sorts of symptoms that emerge from someone suffering from concussion include irritability, lack of coordination, seizures, problems with balance, uneven pupil size, unusual eye movement, vomiting, and lapses in consciousness that could lead to a coma in some cases. These symptoms could keep you out of work for awhile.

High numbers of workplace injuries result in a concussion. For example, in 2013, falling over was the leading cause of concussion, making up 47% of cases, and being hit by or against an object was the 2nd cause (at about 15%). Many of these cases were due to motor vehicle crashes. These figures were provided by OSHA.

Concussions and Workers' Comp

The Cost of Treating a Concussion

Concussions are common brain injuries. The Centers for Disease Control (CDC) reports that 10 percent of all athletes who play contact sports will suffer a concussion every year.

Brain injuries cause more deaths than any other sports injury, so professional athletes are prone to the injuries. Motor vehicle accidents are another leading cause of concussions and traumatic brain injuries (TBIs). Delivery drivers, bus drivers, and truckers might suffer a concussion while in a crash on the job.

Many individuals suffer a concussion or TBI from a fall, which can occur while at work. TBI is a leading cause of disability and death throughout the country. In 2014, there was an average of 155 deaths each day from injuries involving a TBI.

Concussions, like other TBIs, are expensive to treat. The lifetime cost of treating a TBI is estimated to range from $85,000 to $3 million*, according to researchers. Of course, the severity of the concussion and its long-term impact on the accident victim play a role in the cost of the medical care and the overall costs associated with the injury.

Every year, it is estimated that 1.7 million people suffer from a TBI. Families of the accident victim are affected by the financial impact as well as the physical and emotional stressors of caring for the injured loved one.

According to Healthcare.gov, the average cost of treating a concussion is $18,454. Here are some of the expenses associated with the medical treatment of a concussion:

  • Physician visits
  • Hospitalization
  • Prescriptions
  • Physical therapy
  • Occupational therapy
  • Home health services

While some concussions are minor, they do require a few days or weeks of rest and often heal without complications. However, some concussions are more serious, and the injuries and effects are more persistent and debilitating.

Some patients end up developing post-concussion syndrome, which can have long-term effects with symptoms such as light sensitivity, headache disorders, neurodegenerative disease, and migraines. Some patients might have symptoms that linger for years, and of course, require ongoing medical care which will add to the mounting costs.

The symptoms of a concussion fall into four categories – cognitive, emotional, physical, and sleep. While some symptoms might not be apparent, and some may go away in a few days, others may stick around and cause ongoing issues. If that is the case, the patient should continue with medical care to try to make as full recovery as possible. Workers’ compensation laws do vary, but most employers must maintain the coverage to protect their employees if there is a workplace accident or if an employee acquires an occupational disease.

Calculating the Cost of a Concussion Injury

There are several things that come into play when the value of your settlement for a concussion is being determined. First, all your medical expenses must be added up. This includes your total cost of overall medical care.

Many workers’ compensation insurance programs have a network of healthcare providers that will provide care for injured workers. You should ask for a copy of the list of approved providers and seek care from the network so you can make sure your medical care is covered by your employer’s workers’ compensation insurer. Failure to seek care from an in-network provider can lead to your claim being denied, but if it is an emergency, you can seek care from the nearest emergency room and it will be covered.

You can claim the cost of your medical care. This includes all doctor visits, hospitalizations, tests such as scans and x-rays, physical therapy, and prescriptions. Also, workers’ compensation will reimburse you for a portion – usually two-thirds – of your lost pay.

You will need to document your time off work. Also, any future need for medical care and any future missed work and lost wages should also be included in the calculations so all future expenses associated with the injury are considered.

How a Concussion Affects Employment and Compensation

If you fall and hit your head while at work or you were driving a delivery truck, you are usually entitled to workers’ compensation. In most cases, the payment will cover two-thirds of your wages and all medical costs from the onset of the injury to the time medical treatment ceases.

There are certain conditions that could result due to concussion, including:

  • Temporary Total Disability: which is a possibility when you are suffering from concussion. This is because you are unable to undertake normal tasks if you are suffering from headaches and dizziness.
  • Permanent Total Disability: is not likely these days with concussion; treatment is available to help you return to normal life. But normally, Permanent Total Disability means you never return to your job.
  • Temporary Partial Disability: is quite likely with concussion because recovery times can be long. This means that the victim will be unable to undertake job related tasks for some time.
  • Permanent Partial Disability: is unlikely with concussion unless it’s very serious and has reached the stage of serious traumatic brain injury. It means that you can return to work but with a disability.

You Will Need To Provide Evidence to Prove Your Injury

As soon as you fall and hit your head or you are involved in a delivery truck crash, you will know right away that something is not right. You may feel dizzy or even pass out.

You should try to remember to keep a record of how the accident happened. Take down the names of witnesses who can be prepared to vouch for how the work accident took place. Even if you caused the accident, you can still file a claim.

You will be asked to provide all the proof you have before you get your workers’ comp claim accepted, so doing this work in the initial stages will most likely make the later stages of the process simpler.

Settling a Workers’ Compensation Claim For a Concussion

When you are injured at work and suffer a concussion, you will need to file a workers’ compensation claim. Notify your employer as soon as possible of your injury. Be sure to establish medical care right away and maintain thorough documentation of your claim.

This means you need to keep copies of any medical bills and medical records. Be sure to familiarize yourself with the state laws regarding the workers’ comp claim process where you are, so you can ensure everything is filed in a timely manner and that all deadlines are met.

Every workers’ compensation claim varies, so there is no set settlement for a workers’ compensation claim involving a concussion. As previously mentioned, the severity of the injury, the lasting effects, your prognosis, and your disabilities resulting from the accident will all come into play. Maintaining documentation and ensuring an accident report is filed in a timely manner is essential to the success of your workers’ comp claim for a concussion.

You May Need to Hire an Attorney

If you have never experienced a concussion before and you know you can’t return to work, you may need to hire an experienced workers’ compensation attorney. The attorney will analyze your situation and help to ensure you get the workers’ compensation you deserve.

When you enlist the help of a workers’ compensation attorney, your likelihood of a successful workers’ compensation claim increases greatly. Many legitimate workers’ comp claims are denied, and in that case, a lawyer will file an appeal and present the information and documentation necessary to help your claim be approved.

When you hire a workplace accident injury attorney, you will not have to pay anything out of pocket. Instead, your lawyer will take the case on a contingency basis. When a lawyer works on a contingency basis, he or she will not be paid until you win your claim and get a settlement.

If you suffered a concussion in a workplace accident, you should schedule a free consultation with a workers’ compensation attorney who is licensed in your state. Complete the Free Case Evaluation Form so a lawyer in your area can review the details of your case and get your claim underway in a timely manner. Workers’ compensation benefits can have a major impact on your family’s finances while you are recovering from a concussion that you suffered while on the job.

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