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March 4, 2021

Brain injuries in the workplace

The (mostly) invisible workers' comp issue

Cassandra Rudy

A traumatic brain injury is one of the most dangerous on-the-job injuries employees and employers can face. It’s also one of the most difficult to diagnose. But brain injuries can be incredibly costly in terms of insurance and workers’ compensation claims, and their impact can be felt for years.

Brain injuries aren’t limited to concussions. They can be contusions, where the brain is literally bruised; penetrating head wounds such as skull fractures; or an anoxic brain injury, one where the brain is deprived of oxygen. However, concussions are the most common.

Here’s how the Centers for Disease Control (CDC) defines a concussion: A concussion is a type of traumatic brain injury—or TBI—caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells.

Brain injuries don’t necessarily result in overt, recognizable physical problems. That’s why concussions are often referred to as “invisible” injuries. Employees don’t always exhibit breaks or wounds – but they might initially lose consciousness; suffer from dizziness; answer questions slowly or repeat the questions; be irritable or more emotional than before; experience sensitivity to light or have memory issues and headaches, especially migraines.

Understanding the symptoms that indicate a concussive brain injury is vital to making sure the problem is dealt with immediately. The sooner the employee is examined, the sooner treatment can begin. And that can lead to fewer long-term issues.

What are the Exposures?

An employee working in an environment like a construction site or a large assembly line certainly appear more likely to be exposed to a potential brain injury. But any employee in any kind of work environment can be susceptible.

Employees can trip on loose carpeting. They can slip on a staircase, especially one made wet by a leak or spill. They can even simply stand up at the wrong time and seriously injure their heads on open file cabinets. In some cases, brain injuries even occur because of fights between employees.

Most head injuries are not the large, obvious kind. More often, employers are faced with the result of smaller injuries that accumulate over time. Many employees have repeatedly hit their heads in what would seem to be minor ways…but the overall effect can be profound.

Brain injuries are unpredictable. What seems like a mild bump on the head today can become a major problem in the future.

What Should You Do When A Head Injury Happens?

Since a concussion isn’t a visible injury, an employee might appear ready to return to regular work immediately after the injury when that may not be a good idea. An employee who has sustained any form of head injury should be immediately checked for possible concussion. They should be taken to the Emergency Room or Urgent Care for diagnosis and then referred to a specialist, such as a neurologist, if necessary.

Once it’s clear that the employee has a brain injury, they should be encouraged to rest and avoid exertion of any kind, physical or otherwise. Reducing work during this initial period can help recovery.

It’s important to note that brain injury diagnosis is relatively subjective. Physicians look for certain red flag symptoms that indicate the possibility of brain injury. If many or most of those symptoms are present, the common medical wisdom is to err on the side of caution. Medical providers may describe the injury as a “mild” concussion, but all concussions can have serious, debilitating effects.

Can You Prevent the Possiblity of Head Injuries?

To prevent concussions in the workplace, encourage employees to take the following precautions:

  • Remove tripping hazards. Clear walkways and workspaces of clutter, cords, water or anything that could cause a slip, trip or fall.
  • Use proper signage to alert employees of wet surfaces.
  • Use handrails when taking the stairs.
  • Avoid standing on chairs, desks or tables. Use a step stool instead.
  • Use caution when working from heights. Never stand on the top two steps of a ladder.
  • If a job requires wearing a helmet, make sure it’s properly fitted and in good condition.
  • Make sure all vehicles – either warehouse or on-the-road – are well-maintained.
  • Keep objects stored on shelving as secure as possible.

Brain Injuries Can Cost a Lot-- For a Lot of Years

According to the Brain Injury Law Center, the total cost of a serious brain injury can exceed six figures in the first year. Recovery can include speech, occupational and physical therapy – or a combination of all three – from one to four days a week. And it can take months, even years.

Suffering a severe brain injury can incur extremely high recovery costs, including lengthy hospital stays, extensive rehabilitation and medication costs, vocational retraining, and possibly even a personal caregiver or nurse.

On the other hand, most cognitive symptoms clear up within several weeks and many patients recover within three to four months. It’s nearly impossible to predict the outcome.

Workers’ comp should cover medical expenses, lost wages, and training for new skills if the employee is unable to continue performing their original job because of the head injury.

But a brain injury may not be easy for an insurance company to recognize. Your workers’ compensation provider may require an Independent Medical Examination (IME) to give a second opinion and to be certain the treatment given by the patient’s doctor is appropriate and effective.

What Marsh & McLennan Agency Can Do to Help

To learn more about preventing traumatic brain injuries, reacting effectively when they occur, and getting employees back to work in the right amount of time with the right amount of care, contact your local Marsh & McLennan Agency claims representative.