Head Injuries at Work

Quick answer

NIOSH reports that work-related TBI accounts for between 20% and 25% of work-related trauma and that construction has the greatest number of both fatal and nonfatal work-related TBIs of any U.S. industry.[1] Workers’ compensation generally provides benefits for on-the-job injuries regardless of fault and is usually the exclusive remedy against the employer,[2][3] but a claim against a third party may also be possible.

How common work-related TBIs are

A study of fatal occupational TBIs published in the American Journal of Preventive Medicine found:[4]

  • “Nearly 7300 occupational TBI deaths occurred between 2003 and 2008.”
  • The leading causes were motor vehicle incidents (31%), falls (29%), assaults and violent acts (20%) and contact with objects or equipment (18%).
  • Construction, transportation, and agriculture, forestry and fishing recorded nearly half of all TBI fatalities.

Construction

NIOSH reports that from 2003 to 2010, 2,210 construction workers died because of a TBI, representing 25% of all construction deaths in that period.[5] Falls, especially from roofs, ladders and scaffolds, led to more than half of fatal work-related TBIs in construction, and structural iron and steel workers and roofers had the highest fatal TBI rate.[5] Workers at small construction companies (fewer than 20 employees) were more than 2.5 times more likely to die from a TBI than those at companies with 100 or more employees.[5]

Differences by age

The occupational TBI study found that workers 65 and older had the highest TBI fatality rate of any age group, at 2.5 per 100,000 per year.[4] In construction, NIOSH reports that workers 65 and older were almost four times more likely than workers ages 25-34 to have a fatal TBI.[5]

Workers’ compensation

LII explains that workers’ compensation provides fixed monetary awards to employees injured on the job in an attempt to eliminate the need for litigation.[2] The U.S. Department of Labor notes that private-sector and state and local government employees are covered by state programs, while federal workers are covered by federal programs.[6] See workers’ compensation.

The exclusive remedy rule: a federal example

shall be exclusive and in place of all other liability of such employer to the employee

Source: Longshore and Harbor Workers’ Compensation Act, 33 U.S.C. § 905. State workers’ compensation laws contain similar provisions. [7]

Claims against third parties

When someone other than the employer caused or contributed to the injury, such as another company’s driver, a general contractor or the maker of defective equipment, a separate negligence or products liability claim may be possible.[8][9] The compensation insurer may have a lien on that recovery.[10] See third-party claims.

Safety rules

OSHA “requires that fall protection be provided at elevations of four feet in general industry workplaces, five feet in shipyards, six feet in the construction industry and eight feet in longshoring operations.”[11] NIOSH research has found that newer construction helmet designs with an added foam layer offered significantly more protection than basic Type I helmets.[1]

Filing deadlines, shared-fault rules and insurance minimums are set by state law. Our state law pages quote the governing statutes for each state we cover.

Learn more: Workers’ compensation · Third-party claims · Falls

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. NIOSH Science Blog. “Construction Helmets and Work-related Traumatic Brain Injury” (2022). https://www.cdc.gov/niosh/bulletin/2022/construction-helmets.html
  2. Legal Information Institute, Wex. “Workers’ compensation.” https://www.law.cornell.edu/wex/workers_compensation
  3. Reich v. Manhattan Boiler & Equipment Corp., 91 N.Y.2d 772 (1998). Legal Information Institute. https://www.law.cornell.edu/nyctap/I98_0086.htm
  4. “The epidemiology of fatal occupational traumatic brain injury in the U.S.” American Journal of Preventive Medicine, 2011;41(1):61-67. CDC Stacks. https://stacks.cdc.gov/view/cdc/192490
  5. NIOSH Science Blog. “Traumatic Brain Injuries in Construction” (2016). https://www.cdc.gov/niosh/bulletin/2016/brain-injuries-construction.html
  6. U.S. Department of Labor. “Workers’ Compensation.” https://www.dol.gov/general/topic/workcomp
  7. U.S. Department of Labor, OWCP. Longshore and Harbor Workers’ Compensation Act, 33 U.S.C. §§ 905, 933. https://www.dol.gov/agencies/owcp/dlhwc/lhwca
  8. Legal Information Institute, Wex. “Negligence.” https://www.law.cornell.edu/wex/negligence
  9. Legal Information Institute, Wex. “Products liability.” https://www.law.cornell.edu/wex/products_liability
  10. Matter of Brisson v. County of Onondaga, New York Court of Appeals (2006). Legal Information Institute. https://www.law.cornell.edu/nyctap/I06_0015.htm
  11. Occupational Safety and Health Administration. “Fall Protection.” https://www.osha.gov/fall-protection

Sources last checked: October 11, 2026

©Head Injury Resource Center. All rights reserved.