If your concussion is connected to a motor vehicle collision, a fall, or an incident at work, two facts about it will be used against the claim: that you never lost consciousness, and that imaging was normal. Neither fact means what it is presented as meaning, but a bare denial does not answer them. A record does.
The two arguments, and what actually answers them
“There was no loss of consciousness.” Loss of consciousness is one of four alternative criteria in the standard definition of mild traumatic brain injury, not a requirement. It occurs in well under 10% of concussions. And in a prospective study of 1,507 athletes it showed no association with who went on to develop persistent symptoms. It is not a severity marker.
“The CT was normal.” A head CT is a test for bleeding, fracture and mass effect. It is not designed to detect concussion and a normal result does not exclude one. What can be demonstrated instead is objective dysfunction on vestibular and oculomotor testing, and a documented change in function over time.
See Concussion Without Loss of Consciousness for the full evidence and citations.
What a defensible record contains
- A contemporaneous account of the mechanism — what struck what, at what speed, and what the first minutes afterward were like, including whether there was confusion, disorientation or a gap in memory
- An objective examination — vestibular and oculomotor findings that exist independently of what the patient reports
- Structured symptom measures, repeated — the same instrument at intake and follow-up, so the trajectory is documented rather than described
- A functional before-and-after — what the person could do at work, at school and at home before the injury, and what they can do now
- An explicit causation opinion — reasoning stated, not assumed
Why gaps in care become arguments
A delay between the injury and the first documented evaluation will be characterized as evidence that nothing significant happened. So will a gap in treatment. Neither inference is sound — people commonly wait because they were told to expect improvement — but both are effective, and both are avoidable by being seen and documented early.
Roughly 30.5% of athletes in one study reported a prior head injury with concussion symptoms that was never diagnosed as a concussion. Undocumented does not mean it did not happen, but in a claim it is treated exactly as though it did not.
Independent evaluation
An evaluation is more useful when the examination is thorough and the reasoning is written down plainly enough to be checked. That is the standard we work to, whichever side requested the assessment.
We do not offer legal advice and we do not predict case outcomes. What we provide is a documented clinical assessment.
The time to build the record is now, before the symptoms get attributed to stress and the file closes.