Why Head Injuries Are Disputed in Claims

Quick answer

Head injury claims are commonly disputed on four grounds: that the injury doesn’t show up on imaging, that symptoms are subjective, that symptoms started too late to be related, and that something else, such as a prior injury or a mental health condition, explains them. Medical sources address each point: NINDS says imaging can’t always detect mild injuries,[1] and the CDC says symptoms may not appear for hours or days.[2]

“The scans were normal”

CT is used to look for fractures, bleeding and swelling.[1] It is not designed to detect every brain injury. Fewer than 10% of mild TBI patients in the emergency department have CT abnormalities,[3] and in one multicenter study, 27% of mild TBI patients with a normal CT had an abnormal early MRI.[4] See a normal CT scan.

“The symptoms are subjective”

The CDC’s list of mild TBI symptoms includes headaches, dizziness, feeling slowed down, trouble concentrating, memory problems, irritability, sadness and sleep changes,[2] most of which are reported rather than seen on a test. Neuropsychological testing can measure some of these functions,[1] and professional guidance requires those evaluations to address whether results are valid.[5]

“The symptoms started too late”

The CDC states that “some mild TBI and concussion symptoms may appear right away, while others may not appear for hours or days after the injury.”[2] Its HEADS UP program adds that symptoms are usually most severe 1 to 2 days after the injury.[6] See delayed symptoms.

“Concussions heal in a few weeks”

The CDC says most people with a mild TBI feel better within a couple of weeks,[2] but some have symptoms for months or longer.[7] A StatPearls review estimates that about 15% of people with a mild TBI develop post-concussion syndrome.[8]

“Something else explains it”

Defendants often point to prior concussions, migraines, depression, anxiety or age-related changes. Under the eggshell skull rule, a defendant takes the injured person as they find them,[9] but the claim still has to show what the new injury added. See pre-existing conditions.

“It was only a mild TBI”

“Mild” describes how an injury is classified at the time it happens, based on factors such as the Glasgow Coma Scale and loss of consciousness, not how much it affects a person later. The VA’s rating regulation makes the same point, stating that mild, moderate and severe refer to a classification made “at, or close to, the time of injury rather than to the current level of functioning.”[10]

Learn more: Mild, moderate and severe TBI · Post-concussion syndrome

This page provides general information from the sources listed below. It is not legal or medical advice, and reading it does not create an attorney-client or provider-patient relationship. Laws vary by state and change over time. See our legal disclaimer.

Sources

  1. National Institute of Neurological Disorders and Stroke. “Traumatic Brain Injury (TBI).” https://www.ninds.nih.gov/health-information/disorders/traumatic-brain-injury-tbi
  2. Centers for Disease Control and Prevention. “Symptoms of Mild TBI and Concussion.” https://www.cdc.gov/traumatic-brain-injury/signs-symptoms/index.html
  3. Okonkwo DO, et al. “Point-of-Care Platform Blood Biomarker Testing of Glial Fibrillary Acidic Protein versus S100 Calcium-Binding Protein B for Prediction of Traumatic Brain Injuries: A TRACK-TBI Study.” Journal of Neurotrauma, 2020. https://pmc.ncbi.nlm.nih.gov/articles/PMC7698990/
  4. Yuh EL, et al. “Magnetic resonance imaging improves 3-month outcome prediction in mild traumatic brain injury.” Annals of Neurology, 2013;73(2):224-235. https://pubmed.ncbi.nlm.nih.gov/23224915/
  5. Sweet JJ, et al. “American Academy of Clinical Neuropsychology (AACN) 2021 consensus statement on validity assessment.” The Clinical Neuropsychologist, 2021;35(6):1053-1106. https://pubmed.ncbi.nlm.nih.gov/33823750/
  6. Centers for Disease Control and Prevention, HEADS UP. “Signs and Symptoms.” https://www.cdc.gov/heads-up/signs-symptoms/index.html
  7. Centers for Disease Control and Prevention. “What to Do After a Mild TBI or Concussion.” https://www.cdc.gov/traumatic-brain-injury/response/index.html
  8. Permenter CM, Fernández-de Thomas RJ, Sherman AL. “Postconcussive Syndrome.” StatPearls, NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK534786/
  9. Legal Information Institute, Wex. “Eggshell skull rule.” https://www.law.cornell.edu/wex/eggshell_skull_rule
  10. 38 CFR § 4.124a, Schedule of ratings, neurological conditions and convulsive disorders (Diagnostic Code 8045). Legal Information Institute. https://www.law.cornell.edu/cfr/text/38/4.124a

Sources last checked: October 11, 2026

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