• TBIs range from mild concussion to permanent severe disability. The Glasgow Coma Scale classifies TBIs as mild (GCS 13-15), moderate (GCS 9-12), or severe (GCS 3-8). Even mild TBIs can result in prolonged post-concussion syndrome with cognitive, emotional, and physical symptoms lasting months or years. Diffuse axonal injury (DAI), widespread white matter damage from rapid acceleration-deceleration, is among the most severe and most commonly missed TBI types.
  • TBIs are often "invisible" injuries that insurance companies exploit. Mild to moderate TBIs frequently do not appear on standard CT scans or MRIs. Insurance companies routinely argue that because imaging is normal, the injury is not serious or was not caused by the accident. Neuropsychological testing and, where clinically indicated, structural imaging can help document TBI damage that a normal initial scan misses. Functional MRI (fMRI) and diffusion tensor imaging (DTI) remain primarily research tools and are not part of the routine clinical standard for diagnosing TBI, but they may be used in some cases to help document an injury.
  • Lifetime costs for severe TBI can exceed $5 million. According to the Brain Injury Association of America, lifetime care costs for a severe TBI range from $1.6 million (incomplete recovery) to $5.4 million (permanent vegetative state). These figures are illustrative estimates, not a prediction for any specific case; actual costs depend on the individual's injury and treatment needs. A comprehensive TBI claim must account for all future medical costs, not just immediate treatment.
  • Non-economic damages in TBI cases may be capped, depending on when the injury occurred. For injuries occurring on or after September 1, 2025, Oklahoma caps non-economic damages at $500,000 (or $1,000,000 for certain permanent mental injuries) under 23 O.S. § 61.3, unless an exception applies. Because TBI cases so often involve a permanent and severe physical injury, an important exception that removes the cap entirely, or defendant conduct found reckless, grossly negligent, fraudulent, or intentional and malicious, many severe TBI cases will fall outside the cap. Economic damages, including all future medical and care costs, are never capped.
  • Expert testimony is essential in TBI cases. A comprehensive TBI case requires a neurologist or neurosurgeon to establish the diagnosis and prognosis, a neuropsychologist to document cognitive deficits, a life care planner to calculate future care costs, and a forensic economist to calculate lost earning capacity. Without these experts, insurance companies will minimize the claim.
  • The statute of limitations is two years, but act immediately. Under 12 O.S. § 95, you have two years to file a TBI lawsuit. But accident scene evidence, surveillance footage, and witness memories fade quickly. Contact an attorney immediately to preserve evidence and begin the expert retention process.

Traumatic brain injuries (TBIs) are among the most costly and complex personal injury claims in Oklahoma. Lifetime care costs for a severe TBI can range into the millions. TBIs are classified from mild (concussion) to severe (coma, permanent disability) on the Glasgow Coma Scale. Insurance companies routinely challenge TBI claims by arguing the injury is invisible, pre-existing, or exaggerated, requiring neuropsychological testing, imaging, and expert testimony to counter. The statute of limitations is two years under 12 O.S. § 95.

A traumatic brain injury (TBI) can happen in an instant, whether a car crash, a fall, or a blow to the head, and change a person's life forever. TBIs range from mild concussions to severe injuries that result in permanent cognitive impairment, personality changes, loss of motor function, and the inability to live independently.

Types and Classification of Traumatic Brain Injuries

TBIs are classified by severity using the Glasgow Coma Scale (GCS), which measures eye opening, verbal response, and motor response on a scale of 3 to 15:

  • Mild TBI (GCS 13-15, concussion): temporary loss of consciousness (less than 30 minutes), confusion, headache, memory problems, dizziness, and sensitivity to light and noise. Symptoms typically resolve within weeks, but 15-30% of people experience prolonged post-concussion syndrome lasting months or years.
  • Moderate TBI (GCS 9-12): loss of consciousness lasting 30 minutes to 24 hours, significant cognitive and physical impairment that may be permanent. Post-traumatic amnesia lasting 1 to 7 days is common.
  • Severe TBI (GCS 3-8): extended unconsciousness or coma lasting more than 24 hours, permanent cognitive and physical disability, or death. Post-traumatic amnesia lasting more than 7 days.
  • Diffuse axonal injury (DAI): widespread damage to the brain's white matter caused by rapid acceleration-deceleration forces, as in high-speed car crashes. DAI is often not visible on standard CT scans and requires diffusion tensor imaging (DTI) to detect. It is one of the most severe and most commonly missed TBI types.
  • Penetrating TBI: an object penetrates the skull and enters the brain tissue. Common in gunshot wounds and industrial accidents.

Why TBI Cases Are Particularly Challenging

TBI cases present unique legal and medical challenges that make them among the most complex personal injury claims:

The "Invisible Injury" Problem

Mild to moderate TBIs frequently do not appear on standard CT scans or MRIs. Insurance companies exploit this by arguing that because imaging is normal, the injury is not serious or was not caused by the accident. Countering this argument requires:

  • Neuropsychological testing: standardized cognitive testing that documents deficits in memory, attention, processing speed, and executive function
  • Functional MRI (fMRI): a research tool that measures brain activity patterns; not part of the routine clinical standard for diagnosing TBI, but may be used in some cases or in litigation to help document an injury
  • Diffusion tensor imaging (DTI): detects white matter damage (DAI) that standard MRI misses
  • Quantitative EEG (qEEG): measures electrical brain activity patterns associated with TBI

Delayed Symptom Presentation

The full extent of a TBI may not be apparent for months or years after the injury. Cognitive deficits, personality changes, depression, anxiety, and post-traumatic stress disorder (PTSD) may emerge gradually as the brain attempts to heal. This delayed presentation makes it critical to document all symptoms, even those that seem minor, from the earliest possible date after the injury.

Pre-Existing Condition Arguments

Insurance companies routinely argue that TBI symptoms are attributable to pre-existing conditions, such as prior head injuries, depression, anxiety, or ADHD. The eggshell plaintiff doctrine (23 O.S. § 61) holds that a defendant takes the plaintiff as they find them: a person with a pre-existing vulnerability is entitled to full compensation for the aggravation of that condition caused by the defendant's negligence.

Lifetime Costs of Traumatic Brain Injury

According to the Brain Injury Association of America, the lifetime care costs for a severe TBI are substantial. These figures are general estimates, not a prediction or guarantee for any specific case; actual costs depend heavily on the individual's injury, treatment, and long-term needs:

| Severity | Lifetime Cost Estimate | |---|---| | Mild TBI (full recovery) | $85,000 to $3 million | | Moderate TBI (partial recovery) | $941,000 to $1.8 million | | Severe TBI (incomplete recovery) | $1.6 million to $3 million | | Severe TBI (permanent vegetative state) | $3 million to $5.4 million |

A comprehensive TBI claim must account for all of these costs, not just the immediate emergency room and hospital bills.

Compensation for TBI Victims in Oklahoma

A comprehensive TBI claim should account for:

  • Emergency medical care and hospitalization, including neurosurgery, ICU care, and acute rehabilitation
  • Ongoing specialist care: neurologist, neurosurgeon, psychiatrist, and physiatrist visits
  • Rehabilitation: physical therapy, occupational therapy, speech therapy, and cognitive rehabilitation
  • Long-term care and assisted living for severe TBI victims who cannot live independently
  • Lost wages and loss of earning capacity, since TBI frequently prevents victims from returning to their prior occupation or working at all
  • Home modifications and adaptive equipment: wheelchair ramps, modified vehicles, communication devices
  • Pain and suffering and loss of enjoyment of life, under 23 O.S. § 61, subject to the noneconomic damages rules described above
  • Loss of consortium for the victim's spouse and family members
  • Punitive damages, in cases of gross negligence, such as drunk driving (23 O.S. § 9.1)

Frequently Asked Questions

Can I have a TBI if my CT scan was normal?

Yes. Standard CT scans and MRIs frequently miss mild to moderate TBIs, particularly diffuse axonal injury (DAI) and microstructural white matter damage. A normal CT scan does not mean there is no TBI. Neuropsychological testing, and in some cases diffusion tensor imaging (DTI) or functional MRI (fMRI), which remain primarily research tools rather than routine diagnostic ones, can help document TBI-related changes that standard imaging misses. Insurance companies know this and will argue that a normal CT scan means no injury, but an experienced TBI attorney knows how to counter this argument with the right experts.

How long do TBI symptoms last?

It depends on severity. Mild TBI (concussion) symptoms typically resolve within 7 to 14 days, but 15-30% of people experience post-concussion syndrome with symptoms lasting months or years. Moderate TBI symptoms may persist for 1 to 2 years, with some permanent deficits. Severe TBI typically results in permanent cognitive, physical, and behavioral changes. The brain's healing process continues for 2 to 5 years after injury, and the full extent of permanent damage may not be clear for years.

What if I did not lose consciousness? Can I still have a TBI?

Yes. Loss of consciousness is not required for a TBI diagnosis. Many TBI victims experience confusion, disorientation, memory gaps, or a feeling of "seeing stars" without losing consciousness. These are all recognized symptoms of mild TBI under the American Congress of Rehabilitation Medicine (ACRM) definition. Insurance companies often argue that the absence of loss of consciousness means no TBI occurred. This argument is medically incorrect and can be countered with expert testimony.

How is lost earning capacity calculated in a TBI case?

A forensic economist calculates lost earning capacity by comparing the victim's pre-injury earning trajectory with their post-injury earning capacity, accounting for the TBI's effect on cognitive function, physical ability, and employability. A vocational rehabilitation expert assesses what jobs the victim can perform given their TBI-related limitations. In severe cases where the victim cannot work at all, the calculation includes the present value of all future earnings the victim would have earned over their expected working life.

What is the statute of limitations for a TBI claim in Oklahoma?

The statute of limitations for TBI claims in Oklahoma is two years from the date of the injury under 12 O.S. § 95. However, in some cases where the TBI was not immediately diagnosed, for example where symptoms were initially attributed to stress or other causes, the discovery rule may delay the start of the limitations period. Contact an attorney immediately after a TBI diagnosis, regardless of when the injury occurred, to determine whether your claim is still viable.

If you or a loved one has suffered a traumatic brain injury in Oklahoma, call (918) 770-9775 for a free consultation. I handle TBI cases on a contingency fee basis: you pay nothing unless we win.