A serious brain injury affects more than one person — the person who has it, and the people closest to them.
If you're reading this for yourself, you may already be having trouble finishing pages like this one.
If you're reading it for someone else — a husband, a daughter, a parent who came home from the hospital and hasn't been the same since — you're probably the person who noticed first, and you may be the only one who has.
A brain injury is the hardest injury to prove precisely because it is the hardest to see. There is no cast. Scans frequently come back normal. The person walks, talks, and answers questions, and to anyone who didn't know them before, they seem fine. Meanwhile they cannot hold a thought, cannot tolerate noise, lose their temper over nothing, sleep twelve hours and wake exhausted, and cannot do the job they did competently for fifteen years.
The people evaluating the claim have a financial reason to call that "minor." Building the case means making an invisible injury visible, in documents, to people who have never met the person you knew before.
Making that case is what Boyadzhyan Legal Shield does on brain injury claims, and the work starts long before anyone talks about settlement. We represent injured people and the families managing this alongside them, from the first call through resolution, across Los Angeles, the San Fernando Valley, and San Bernardino County.
Knarik Boyadzhyan spent years as a Los Angeles County Deputy Public Defender, challenging the other side's version of events. Brain injury claims reward that same experience. The insurance company disputes how serious the injury is and what it took away, and much of the proof comes from people who knew the person before. It matters to bring a lawyer in while those memories are still fresh and the records still exist.
You concentrate on the recovery, whether it's your own or someone else's. We'll concentrate on the claim.
A traumatic brain injury is damage to the brain caused by an external force — a blow, a jolt, a violent movement of the head, or an object penetrating the skull. It does not require the head to strike anything. Rapid acceleration and deceleration alone can do it, which is why these injuries occur in collisions where the head never made contact with anything.
Clinically, brain injuries are classified as mild, moderate, or severe, generally based on things measured at the time of injury: the person's responsiveness, whether consciousness was lost and for how long, and how much memory around the event was lost.
The word "mild" causes an enormous amount of harm in these cases. It is a clinical description of how the injury presented in the first hours. It is not a prediction about recovery and it is not a statement about how serious the consequences will be. A person can be classified as having a mild traumatic brain injury and never return to their previous work.
A concussion is a traumatic brain injury. People frequently do not understand this, including people who were told at an emergency room that they had "just a concussion" and sent home with a pamphlet.
Symptoms also don't always appear immediately. Some emerge or worsen over days and weeks, which creates a records problem: the initial medical documentation may describe someone who seemed fine, and that document will be used later.
Nothing on this page is medical information about your situation. What symptoms mean, how serious an injury is, and what recovery looks like are questions for your doctors. What we handle is how an injury already diagnosed gets established in a legal claim.
Insurers and defense attorneys approach brain injury claims with a standard set of arguments. Knowing them in advance is the difference between being blindsided and being prepared.
Standard CT and MRI imaging is designed to find bleeding, swelling, and structural damage. A great deal of traumatic brain injury does not appear on them, particularly the diffuse damage associated with rapid acceleration. A normal scan is not evidence that nothing happened, and any physician will say so. It is still the first thing raised.
Brain injuries frequently spare the abilities used in a short conversation and damage the ones used to work, plan, tolerate frustration, and get through a day. Someone can present well for twenty minutes at a deposition and be unable to function by the afternoon.
Any prior history — depression, anxiety, a previous concussion, ADHD, a difficult period, substance use — becomes the alternative explanation. Prior treatment records will be obtained and read closely.
Symptoms of brain injury overlap substantially with depression and anxiety, and the claim will be recharacterized as an emotional reaction rather than a physical injury.
Gaps in treatment are read as evidence of recovery, when they're often evidence of a person who cannot manage appointments, cannot drive, or ran out of money.
What actually establishes these injuries is not a single dramatic document. It is convergence: neuropsychological testing measuring specific cognitive functions against expected baselines, treating specialists who document the course over time rather than a one-time examiner, records from before the injury showing who the person was, and testimony from people who knew them — a supervisor, a colleague, a spouse, a friend — describing the difference in concrete terms.
That last category is the one families don't know to build, and it's often the most persuasive evidence in the case.
California divides injury damages into two categories, and brain injury cases involve both in ways that most injury claims do not.
Economic damages are measurable financial losses. Non-economic damages cover what doesn't appear on a receipt — pain, suffering, emotional distress, and loss of enjoyment of life. In a serious brain injury case, the second category is often where the greater loss lies, because what was taken was the person's ability to be who they were.
Here's what has to be established, and how.
What's recoverable isn't the total of the bills. It depends on how the care was paid for. An amount a health insurer actually paid and settled is measured differently from the reasonable value of services for someone uninsured, and the gap between those two figures can be substantial.
This is frequently the largest single number in a serious brain injury case, and it cannot be estimated. It's established through a life care plan, prepared by a qualified professional, projecting what the person will need over a lifetime: physicians, neuropsychological care, therapies, medications, assistive technology, home modification, attendant care, and case management. An economist then reduces those projected costs to present value.
These are different, and the difference matters enormously. Lost earnings are what the person did not earn while unable to work. Lost earning capacity is the difference between what they could have earned over a working lifetime and what they can earn now. For someone injured at 34 in a career with a trajectory, capacity is usually the far larger figure. It's established through vocational assessment and economic analysis, working from actual work history, education, and the specific limitations the injury imposes.
What the person can no longer do — childcare, driving, home maintenance, managing finances — has a replacement cost, and it's recoverable.
A spouse has their own separate claim for the loss of companionship, intimacy, and the partnership they had. It belongs to the spouse rather than the injured person, and it's regularly overlooked.
These are established by evidence of daily reality, not by argument. This is where contemporaneous records of what a day actually looks like carry more weight than any expert.
This is what families are actually lying awake about.
Using your own health coverage doesn't reduce what the responsible party owes. Under California's collateral source rule, established in Helfend v. Southern California Rapid Transit District (1970) 2 Cal.3d 1, compensation from a source independent of the wrongdoer is not deducted from what they must pay. What does happen is that your insurer typically has a right to be reimbursed out of any recovery. Medi-Cal, Medicare, and employer plans all have their own reimbursement rules, and those amounts are frequently negotiable at the end of a case.
Many auto policies include medical payments coverage that pays regardless of fault, usually in modest amounts, and it's available immediately. People routinely forget they have it. It sits on your own policy rather than the other driver's, so it doesn't wait on anyone admitting fault, and your declarations page will say whether you carry it and for how much. Whether it has to be repaid out of a later recovery depends on the policy, which is worth checking early rather than assuming either way.
Some providers will treat now and be paid from a future recovery. This is common where someone is uninsured or where the care they need isn't available through their plan. It isn't free care. The provider is paid out of the settlement, so it comes out of what you receive, though those amounts are frequently negotiated down at the end of a case. What it buys is continuous treatment, and that matters more than it sounds: gaps in the record get read as evidence of recovery.
California law treats the measure of past medical damages differently depending on how care was paid for. Where a health insurer paid, recovery for past medical expenses is generally limited to the amount actually paid and accepted as payment in full, rather than the amount originally billed — that's the rule from Howell v. Hamilton Meats & Provisions (2011) 52 Cal.4th 541. Where a person is uninsured, or has insurance but treats outside their plan, the measure generally turns on the reasonable value of the services instead, following Pebley v. Santa Clara Organics (2018) 22 Cal.App.5th 1266.
We're not suggesting there's a right answer to that for everyone, and how someone gets treatment should be driven by their medical needs. But it's a decision with legal consequences that most people make in the first weeks without knowing there was a decision to make. It's worth a conversation early rather than discovering the effect at the end.
The bills arriving now are not evidence that nobody is responsible. They're evidence that the system bills immediately and resolves later. That's normal, and it's manageable.
Particularly the description of how the injury happened and what was observed at the scene. Whether loss of consciousness was noted, and what the person could recall, matters later far out of proportion to how carefully it was written down at the time.
Including why particular studies were or were not ordered.
The core objective evidence in most brain injury cases. Timing affects interpretation, so this is worth coordinating rather than leaving to chance.
Performance reviews, work product, academic records, prior medical records showing the absence of these problems, and correspondence in their own words from before the injury. Defense counsel will look for a prior explanation, and pre-injury records are the answer to it.
Missed days, accommodations, discipline, reduced responsibilities, and eventual separation. A supervisor who noticed a change is a valuable witness and may move on within months.
And the one thing only a family can do: start keeping notes today.
Write down what happens on ordinary days. What was forgotten, what conversation went wrong, how long a simple task took, what had to be given up, and who had to help and with what. Date each entry.
This is the most valuable evidence in a brain injury case and it cannot be recreated later. A year from now, no one will remember which week the arguments started, and everyone will have adjusted so gradually that the change becomes invisible from inside the household. A contemporaneous record written by someone who lived it carries a weight no expert report matches.
California generally allows two years from the date of injury to file a personal injury lawsuit.
There's a major exception. If a public entity was involved — a city vehicle, a transit bus, a government-owned property, a public hospital — a written claim generally must be presented to that agency within six months, long before the two-year period would run. The full process is on our government liability page.
Brain injury cases raise timing questions that other cases do not, because the injury is sometimes not identified for weeks or months. Whether that affects your dates is fact-specific and worth confirming rather than assuming.
If your injury happened on a bus, see our bus accident page, which also covers what happens when fault is shared.
Knarik Boyadzhyan served as a Deputy Public Defender, representing clients facing criminal charges at every stage. In a brain injury case that matters more than in most, because these are the claims insurers most often decide to test. A file being genuinely prepared for trial is valued differently from one that is not, and the difference shows up in what gets offered.
You'll also be working directly with the attorney handling your case rather than a case manager. In a case where the details of daily life are the evidence, having the person who will try the case be the person who hears those details is not a luxury.
Employment records, performance history, and the people who can describe the person before. This evidence has a shelf life measured in job changes and fading memory.
Treating specialists who document a course over time are more persuasive than any one-time examiner, and what appears in the records depends partly on whether anyone asked the right questions.
Life care planning, vocational assessment, and economic analysis, engaged early enough to do real work rather than assembled before a mediation.
Surveillance, social media review, and an examination by a defense-selected physician are routine in serious brain injury cases. Nobody should encounter those for the first time without warning.
Multiple defendants, multiple policies, underinsured motorist coverage, and med-pay. In a case where lifetime costs are the measure, available coverage often determines what's actually recoverable.
If you're the family member, this is the single most useful thing you can do, and today is the earliest it can start.
Gaps in treatment become an argument that the injury resolved. If appointments are hard to manage — and they often are, for exactly the reasons at issue — tell someone, so the reason is documented.
Performance reviews, pay records, school records, prior medical history. These get harder to obtain as time passes and employers change systems.
Names and contact information for anyone who has commented on a change: coworkers, supervisors, friends, teachers, family. People move and become unreachable.
Not to any insurer, including your own beyond basic claim reporting. In a brain injury case, an early recorded statement given by someone who's impaired and doesn't yet understand their own condition is among the most damaging things that can happen.
Photographs from a good hour on a good day are used to argue that nothing is wrong.
With brain injuries there may not be one for a long time, and deadlines run regardless.
If your question is not answered here, call (310) 877-7770 to discuss your situation.
Boyadzhyan Legal Shield represents people with traumatic brain injuries and their families throughout Los Angeles County from our office in Encino. If you're managing this for someone else, we're used to that conversation and we can have it with you.
How fees and costs work is set out in a written agreement we go through with you before you sign anything.
Initial consultations are free and confidential.
This page is general legal information, not legal advice, and does not create an attorney-client relationship.
Should You Accept the Insurance Company's First Settlement Offer?
A settlement trades the claim for payment and a release. Evaluate medical status, losses, liens, coverage, disputed fault, and the release before deciding.
Personal InjuryShould You Give the Insurance Company a Recorded Statement?
Before giving a recorded statement, identify the insurer, policy, instrument, scope, and asserted basis. A first-party request differs from an adverse carrier's interview.
Personal InjuryHow a California Personal Injury Claim Works
A California injury claim moves through a series of proof and decision stages, from investigation and insurance review to negotiation and, when needed, a lawsuit.
