The Hidden Injury: Why 'Mild' Traumatic Brain Injuries Are Anything But

You didn't lose consciousness—or if you did, it was only for a few seconds. The ER did a CT scan and said everything looked fine. You were sent home with instructions to watch for warning signs. But weeks later, you're still not right. You can't concentrate. Lights bother you. You forget conversations. You're irritable in ways you never were before. When you try to explain this to the insurance adjuster, they point to the medical records: "mild traumatic brain injury." Emphasis on mild. Case closed.

Except it's not. For thousands of Oklahomans living with the lingering effects of so-called "mild" TBIs, there is nothing mild about their experience. This article explains what a mild TBI actually means, why insurance companies exploit this terminology, and how to prove and value these often-invisible injuries.

What Is a "Mild" TBI?

The Medical Definition

A traumatic brain injury (TBI) occurs when an external force causes damage to the brain. TBIs are classified by severity based on initial clinical presentation:

Classification	Loss of Consciousness	Post-Traumatic Amnesia	Glasgow Coma Score
Mild	0-30 minutes	Less than 24 hours	13-15
Moderate	30 min - 24 hours	1-7 days	9-12
Severe	More than 24 hours	More than 7 days	3-8

A "mild" TBI—which includes concussions—is defined by a brief or absent loss of consciousness, relatively short confusion, and a Glasgow Coma Score at the higher end of the scale.

What "Mild" Does NOT Mean

The classification refers to the acute presentation—what happened in the first hours after injury. It says nothing about:

• How long symptoms will last
• Whether the victim will fully recover
• The impact on the person's life, work, and relationships

Up to 15-30% of mild TBI patients experience persistent post-concussive symptoms lasting months or years. For some, these symptoms become permanent.

Calling an injury "mild" because the victim didn't fall into a coma is like calling a heart attack "mild" because the patient survived. Survival doesn't mean the damage wasn't serious.

Common Symptoms of Mild TBI

Mild TBI symptoms are often invisible to others but profoundly disruptive to victims:

Cognitive Symptoms

• Difficulty concentrating or multitasking
• Memory problems (especially short-term memory)
• Slowed thinking and processing speed
• Difficulty finding words
• Problems with planning and organization

Physical Symptoms

• Headaches (often daily or constant)
• Dizziness and balance problems
• Fatigue and sleep disturbances
• Sensitivity to light and noise
• Tinnitus (ringing in the ears)
• Blurred vision

Emotional/Behavioral Symptoms

• Irritability and mood swings
• Anxiety and depression
• Personality changes
• Difficulty controlling emotions
• Social withdrawal

The Cascade Effect

These symptoms compound each other. Fatigue makes concentration harder. Poor concentration increases frustration. Frustration damages relationships. Damaged relationships cause depression. Depression worsens fatigue. The victim spirals—and from the outside, they look "fine."

Why Insurance Companies Love the Word "Mild"

The Minimization Playbook

Insurance adjusters are trained to control language. When they see "mild TBI" in medical records, they weaponize it:

• "The records say it was mild—this isn't a serious injury."
• "You didn't lose consciousness, so how bad could it be?"
• "The CT scan was normal, so there's no brain damage."
• "You returned to work, so you must be fine."

Every one of these arguments is medically inaccurate. But they work on juries who don't understand TBIs—which is why insurance companies use them.

The "Normal" Imaging Problem

Standard CT scans and MRIs are designed to detect structural damage—bleeding, swelling, fractures. They are not sensitive to the diffuse axonal injury that characterizes most mild TBIs.

Diffuse axonal injury occurs when the brain's nerve fibers (axons) are stretched and damaged by acceleration/deceleration forces. The damage is microscopic, scattered throughout the brain, and invisible on routine imaging.

When an adjuster says "the CT was normal, so there's no brain injury," they're revealing ignorance—or hoping you share it.

Advanced Imaging Options

Newer imaging technologies can sometimes detect mild TBI damage:

• Diffusion tensor imaging (DTI): An MRI technique that maps white matter tracts and can show axonal damage
• Functional MRI (fMRI): Shows brain activity patterns that may differ in TBI patients
• PET scans: Can reveal metabolic abnormalities

These aren't routinely ordered in the ER, but they can be valuable in litigation to prove objective brain damage.

Building a Mild TBI Case

The Proof Challenge

Unlike a broken arm with a visible X-ray, mild TBI requires building a case from multiple sources:

1. Mechanism of Injury

Document how the injury occurred. Was there enough force to cause a brain injury?

• Vehicle speed and collision dynamics
• Fall height and impact surface
• Whether the victim's head struck anything
• Whether there was a whiplash-type acceleration/deceleration

2. Contemporaneous Symptoms

Early documentation of symptoms is critical. This includes:

• ER records noting confusion, disorientation, or amnesia
• Follow-up visits documenting headaches, dizziness, cognitive complaints
• Work absences and performance problems
• Statements from family members about observed changes

3. Neuropsychological Testing

A neuropsychological evaluation is the gold standard for documenting cognitive deficits from mild TBI. A neuropsychologist administers a battery of standardized tests measuring:

• Attention and concentration
• Memory (working, short-term, long-term)
• Processing speed
• Executive function (planning, organization, problem-solving)
• Language and communication
• Emotional functioning

The results are compared to normative data and the patient's estimated pre-injury functioning. Deficits in specific domains—particularly processing speed and memory—are classic mild TBI findings.

4. Before-and-After Evidence

Jurors understand transformation. Show them who the victim was before the injury and who they are after:

• Academic and work performance records
• Co-worker and supervisor testimony
• Family and friend observations
• Hobby and activity participation
• Social media posts (showing pre-injury activity levels)

5. Expert Testimony

Mild TBI cases typically require:

• Neurologist or physiatrist: To diagnose the TBI and explain the injury mechanism
• Neuropsychologist: To document cognitive deficits
• Vocational expert: To explain impact on earning capacity
• Life care planner: To project future treatment needs
• Economist: To calculate lifetime losses

What NOT to Do

Don't Minimize to Others

Victims often try to push through symptoms, telling employers and family they're "fine." This creates a record that contradicts your claim. Be honest about your limitations.

Don't Skip Follow-Up Care

If you stop seeking treatment, insurers argue you recovered. Continue with recommended neurology visits, therapy, and cognitive rehabilitation.

Don't Assume You'll "Just Get Better"

Some mild TBI victims do recover fully within weeks. Others don't. Don't delay legal consultation hoping symptoms will resolve—deadlines are running.

Damages in Mild TBI Cases

Medical Expenses

• Emergency room and initial hospitalization
• Neurologist and specialist consultations
• Neuropsychological testing
• Cognitive rehabilitation therapy
• Vestibular therapy (for balance/dizziness)
• Psychiatric care and counseling
• Medications (for headaches, sleep, mood)
• Future medical needs (ongoing monitoring, therapy)

Lost Wages and Earning Capacity

Mild TBI often impairs the cognitive abilities that high-level jobs require:

• Reduced productivity even when working
• Need to shift to less demanding positions
• Inability to work full-time
• Career trajectory derailment

A 30-year-old professional earning $80,000/year who can now only handle $50,000/year work has lost $30,000/year for potentially 30+ working years—nearly $1 million before adjustments.

Pain and Suffering

Daily headaches, constant fatigue, and the frustration of cognitive limitations cause real suffering—even if invisible. Jurors who understand the reality of mild TBI can award substantial pain and suffering damages.

Loss of Consortium

Spouses and children suffer when a family member's personality, patience, and capabilities change after TBI. Loss of consortium claims compensate for these relational harms.

The "Eggshell Plaintiff" Rule

What if the victim had a prior concussion, pre-existing anxiety, or other vulnerabilities? Under Oklahoma's eggshell plaintiff doctrine, defendants take victims as they find them.

If a prior concussion made this accident's effects worse, the defendant is liable for all resulting harm—even if someone without that history would have recovered faster.

Insurance companies often try to blame pre-existing conditions. An attorney can counter this with expert testimony explaining that the accident triggered or worsened symptoms, making the defendant fully liable.

Second Impact Syndrome: The Worst-Case Scenario

A dangerous complication arises when someone who hasn't recovered from a first concussion suffers a second impact. Second Impact Syndrome can cause rapid, catastrophic brain swelling—sometimes fatal.

This is most common in young athletes who return to play too soon after a concussion. If a coach, school, or athletic organization allowed return-to-play without proper clearance, they may be liable for resulting injuries.

Statute of Limitations

Oklahoma's statute of limitations for personal injury claims is two years from the date of the accident. However, mild TBI symptoms sometimes develop or worsen gradually, creating questions about when the clock starts.

Don't wait. Consult an attorney early to preserve your rights and begin building the documentation necessary for a mild TBI case.

Frequently Asked Questions

If the CT scan was normal, how can I prove I have a brain injury?

CT scans detect structural damage like bleeding—not the microscopic axonal damage that causes most mild TBIs. Neuropsychological testing documents cognitive deficits, and advanced imaging (DTI, fMRI) can sometimes show injury invisible on CT.

The insurance company says my symptoms are "subjective"—what does that mean?

They're implying your symptoms are exaggerated or fabricated. Counter this with objective neuropsychological test results, consistent medical records, and before-and-after testimony from people who know you.

How long do mild TBI symptoms last?

Most mild TBI victims recover within weeks to months. But 15-30% have persistent symptoms lasting a year or longer, and some never fully recover. Recovery depends on injury severity, age, prior concussions, and individual factors.

Can I get compensation if I already had anxiety or depression before the accident?

Yes. Under the eggshell plaintiff rule, defendants are liable for worsening pre-existing conditions. If the accident made your anxiety or depression significantly worse, you can recover for that worsening.

Should I see a neurologist even if the ER said I was fine?

Yes. ER physicians are trained to identify life-threatening emergencies—not to assess long-term TBI outcomes. A neurologist can provide proper evaluation, treatment recommendations, and documentation for your case.

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The word "mild" in mild traumatic brain injury is perhaps the most damaging misnomer in medicine. It leads victims to minimize their own suffering, employers to doubt their limitations, and insurance companies to lowball their claims. But there is nothing mild about living with persistent cognitive impairment, daily headaches, and the frustration of knowing you're not who you used to be.

At Addison Law, we represent mild TBI victims throughout Oklahoma. We understand the medical complexity of these cases and know how to counter insurance tactics that exploit the "mild" label. We work with neuropsychologists, vocational experts, and life care planners to document and prove the true impact of your injury. Contact us for a free consultation.

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This article is for general information only and is not legal advice.