Traumatic Brain Injury at Work

TBI Severity Classification and What It Means for Your Claim

TBI is classified by the Glasgow Coma Scale (GCS) score measured at or shortly after injury, along with duration of loss of consciousness and post-traumatic amnesia. Mild TBI (GCS 13-15) with brief or no loss of consciousness includes concussion. Moderate TBI (GCS 9-12) involves loss of consciousness up to 24 hours and significant post-traumatic amnesia. Severe TBI (GCS 3-8) involves prolonged unconsciousness and often significant structural brain damage. However, these initial classifications do not always predict long-term outcomes — some "mild" TBI victims suffer permanent cognitive effects that significantly impair their ability to work and enjoy life. The severity classification affects damages calculation but does not limit the range of compensation available.

How Industrial Accidents Cause TBI

• Falls from scaffolding, ladders, and elevated structures — head strikes on surfaces or ground
• Being struck by falling tools, materials, or structural members
• Forklift and heavy vehicle rollovers — cab crush and head impact
• Blast injuries from chemical plant, refinery, or mining explosions — primary blast wave causes diffuse axonal injury
• Vehicle accident — collision or rollover while performing work-related driving
• Electrocution — anoxic brain injury if cardiac arrest results from electrical current
• Machine entrapment — compression forces on the head

Medical Evidence in TBI Claims

Building a successful TBI claim requires layered medical evidence from multiple specialists. Emergency medicine and trauma records document the acute injury, GCS score, loss of consciousness, and early imaging. Neurology and neurosurgery records document the diagnosis, treatment, and initial prognosis. Neuropsychological testing — a battery of standardized cognitive assessments administered by a licensed neuropsychologist — documents specific deficits in memory, attention, processing speed, executive function, and verbal and visual skills, and can detect impairments not apparent in clinical examination.

For moderate to severe TBI, advanced neuroimaging including diffusion tensor imaging (DTI) can visualize axonal damage in white matter tracts that standard MRI misses. Neuropsychiatric evaluation documents behavioral and emotional changes. A life care planner integrates all medical findings into a future care plan with associated costs. These experts' opinions must be thoroughly developed and disclosed during litigation to support the damages claimed.

Cognitive and Behavioral Effects of Industrial TBI

The cognitive and behavioral effects of moderate to severe TBI are often the most disabling aspects of the injury for industrial workers. Memory impairment — difficulty learning and retaining new information — interferes with following safety procedures, learning new tasks, and maintaining employment. Attention and concentration deficits make it difficult to sustain performance on cognitively demanding work. Executive function impairment — difficulty with planning, organization, problem-solving, and impulse control — can make independent work impossible. Behavioral and emotional changes including irritability, depression, anxiety, and disinhibition affect relationships and workplace functioning. These invisible effects are often underestimated by insurers and defendants, making expert neuropsychological evidence essential.

Third-Party Liability in Work-Related TBI Cases

Work-related TBI from an industrial accident may involve third-party liability beyond the employer's workers' compensation. Where a fall occurred because a scaffold was defectively manufactured, a manufacturer may face product liability. Where inadequate fall protection by a general contractor contributed to a fall, the GC may face civil liability. Where a machine struck the worker due to inadequate guarding, the machine manufacturer is a potential defendant. Where a forklift lacked adequate overhead guards or rollover protection, the vehicle manufacturer faces liability. Because TBI damages — including lifetime cognitive care, lost earning capacity, and non-economic losses — are often the largest of any work-related injury, pursuing all available defendants through civil litigation is essential.

See also: falls from heights, PTSD after a workplace accident, and industrial accident damages.