Families describe it the same way again and again: the person came home, the scan was clear, and they were not the same. Short temper, lost words, exhaustion by mid-afternoon, an inability to hold two things in mind at once. Everyone else was told it was a mild concussion.
The word "mild" in "mild traumatic brain injury" describes how the injury presented in the first hours, not how much it will affect a life. Insurers use that word as if it meant the opposite.
Why a normal scan proves less than you were told
A CT scan in an emergency department is looking for bleeding and swelling — the things that kill people that night. It is very good at that, and it is not designed to detect diffuse injury to the connections between brain cells.
So a clear CT means you were not bleeding. It does not mean your brain was not injured. Standard MRI often adds little in these cases either, which is why the diagnosis rests on other evidence:
- The clinical record from the scene onward: loss of consciousness, confusion, amnesia around the event, what was recorded in triage
- Neuropsychological testing, which measures memory, processing speed, attention and executive function against expected performance
- Treating specialists: neurology, neuropsychology, rehabilitation medicine, speech and language therapy
- The documented course of symptoms over months, which is what distinguishes a brain injury from a bad few weeks
The before-and-after witnesses
In practice the most persuasive evidence in a brain injury claim is not medical at all. It is the people who knew the person before.
A supervisor who explains that a reliable employee now needs written instructions for a task they used to do from memory. A spouse describing the lists that appeared all over the house. A teacher describing a student whose grades fell off a cliff after a crash. A friend who stopped being invited out because noise and crowds became unbearable.
Gathering those accounts early, while the contrast is fresh and specific, is a substantial part of the work — and it is why we ask families to write things down from the start rather than reconstruct them two years later.
What actually changes after a brain injury
- Cognitive: memory, attention, word-finding, processing speed, doing more than one thing at a time
- Executive function: planning, organizing, starting tasks, judgment — often the most disabling and the least visible
- Personality and mood: irritability, disinhibition, flat affect, depression and anxiety
- Physical: headaches, dizziness, balance problems, light and noise sensitivity, and a fatigue unlike ordinary tiredness
- Sleep, which is disrupted in most cases and makes everything else worse
- Sensory: vision, smell and taste changes, tinnitus
Severe injuries add seizure disorders, motor impairment and the need for supervision or full-time care. Where an injury leaves someone unable to return to work or to live independently, the claim has to be valued over a lifetime rather than against the treatment received so far.
How these injuries happen
- [Vehicle collisions](/car-accident-lawyer/), including crashes with no head strike at all, where the brain moves inside the skull
- [Motorcycle](/motorcycle-accident-lawyers/) and [pedestrian](/pedestrian-accident-attorney/) collisions, where the head takes the impact directly
- [Falls](/slip-and-fall-lawyer/), the leading cause in older adults and young children
- Struck by falling objects, common on work sites
- Assaults, including where inadequate security made the attack possible
- Oxygen deprivation, including injury around the time of birth, which is handled as a birth injury claim
How these claims get attacked
- "The imaging is normal." Addressed above, and answered with neuropsychological evidence.
- "It is pre-existing." Prior headaches, prior depression, a prior concussion — all offered as the real explanation.
- "They are exaggerating." Brain injury claims draw surveillance and social media review more than almost any other.
- "They stopped treatment, so they recovered." Gaps in treatment are common precisely because the injury impairs the organization needed to keep appointments.
- Contributory negligence. Under Maryland’s rule, any meaningful share of fault assigned to you can defeat the claim entirely, whatever the injury.
What a brain injury claim has to cover
Medical and rehabilitative treatment, including cognitive and vocational rehabilitation. Lost earnings, and lost earning capacity where someone cannot return to the work they trained for. Care and supervision. Home adaptation in severe cases. The personal harm, including the loss of the life the person had.
Maryland caps non-economic damages and adjusts that cap over time; the care and earnings side is not capped, which is why serious cases are valued from a life care plan and an economic analysis rather than from bills to date.
Deadlines
Maryland generally allows three years from the injury to file, with different rules for children and for a death, and much shorter written notice where a government body is involved.
Brain injury cases are frequently brought late for an understandable reason: the person did not realize how much had changed until they tried to go back to work. If that is where you are, ask now.
