A knock to the head at work is easy to dismiss. Someone clips a steel beam, slips off a stepladder or is struck by something dropped from above. They feel dazed for a few minutes, say they are fine and finish the shift. Then the headaches start, concentration slips, sleep becomes unreliable and colleagues begin to notice that the person is not quite themselves.
This guide explains how head injuries are classified, which symptoms matter, what an employer is legally expected to do, and what a compensation claim involves when the injury is to the brain.
Concussion and traumatic brain injury: what is the difference?
A traumatic brain injury (TBI) is damage to the brain caused by an external force, such as an impact, a fall or a sudden violent movement of the head. Concussion is the mildest form of TBI. Most people with concussion are never knocked out, so the absence of a blackout does not rule it out.
Doctors usually grade the severity of a TBI using the Glasgow Coma Scale, which scores a person’s responsiveness at the time of assessment:
- Mild: a score of 13 to 15
- Moderate: a score of 9 to 12
- Severe: a score of 8 or below
The word “mild” describes how the person presented shortly after the injury. It says very little about the effect on their life. A mild TBI can leave someone unable to hold down a skilled job for months.
TBI is also not the only head injury seen in workplace accidents. Skull fractures, bleeding on or around the brain and injuries caused by the brain twisting inside the skull (diffuse axonal injury) are all possible, particularly after falls from height or vehicle impacts.
Symptoms that should not be ignored
The early signs of a head injury often include headache, dizziness, nausea, blurred vision, confusion, sensitivity to light or noise, and a gap in memory around the accident itself.
The longer-term picture can look quite different. Persistent fatigue, irritability, anxiety, low mood, poor concentration, difficulty finding words and disturbed sleep are common in the weeks and months afterwards. Many people only notice these changes when a partner, relative or colleague points them out, because brain injury can reduce a person’s awareness of their own difficulties.
Call 999 or go straight to A&E if a head injury is followed by any of the following:
- Loss of consciousness, even briefly
- Repeated vomiting
- A seizure
- Clear fluid or blood coming from the nose or ears
- Weakness, numbness or problems with speech or balance
- Increasing drowsiness, confusion or a headache that keeps getting worse
How head injuries happen at work
The causes are rarely unusual. The most frequent are falls from ladders, scaffolding, roofs and loading bays, objects falling from height, collisions involving forklifts and other vehicles, slips and trips on wet or cluttered floors, and being struck by moving machinery. Assaults on staff in retail, hospitality, security and healthcare also cause head injuries.
Behind many of these accidents sits a preventable failing: no head protection supplied where there was a clear overhead risk, missing edge protection, poorly maintained equipment, no exclusion zone beneath work at height, or workers who were never trained properly.
What an employer is required to do
Employers owe their staff a legal duty of care, and several sets of regulations give that duty some detail:
- The Management of Health and Safety at Work Regulations 1999 require a suitable risk assessment and sensible measures to control the risks it identifies.
- The Personal Protective Equipment at Work Regulations 1992 require suitable protective equipment, including head protection, where a risk cannot be controlled in another way.
- The Work at Height Regulations 2005 cover ladders, scaffolding, roofs and any other work where a fall could cause injury.
- The Provision and Use of Work Equipment Regulations 1998 require equipment to be suitable, maintained and used by trained people.
After an accident, the employer should record it in the accident book. A head injury that causes loss of consciousness is a “specified injury” under RIDDOR, which means it must be reported to the Health and Safety Executive. So must any injury that stops a worker doing their normal duties for more than seven days. Whether a report was made, and what it says, can become important evidence later.
Can you claim? Establishing fault
A head injury at work does not automatically mean the employer was negligent. An accidents at work claim succeeds where it can be shown that the employer breached a duty owed to the worker and that the breach caused the injury. A worker who falls because a ladder was defective and had never been inspected has a strong case. A worker who trips over their own shoelace probably does not.
Two practical points worry people more than they should. First, employers are legally required to hold employers’ liability insurance, so a claim is dealt with by the insurer rather than being paid out of the employer’s own pocket. Second, if the worker contributed to the accident, for example by ignoring a clear instruction to wear a hard hat that had been provided, compensation may be reduced for contributory negligence. The claim is not usually defeated altogether.
What to do in the days after a head injury at work
The steps taken early shape the strength of a claim far more than most people expect.
- Get checked by a medical professional, even if symptoms seem minor. Scans can look normal after a mild TBI, but an A&E or GP record created close to the accident proves that the injury was reported at the time.
- Make sure the accident is in the accident book, and ask for a copy of the entry.
- Collect the details of anyone who saw what happened. Photograph the area and any equipment involved, and ask your employer to preserve CCTV footage, which is often overwritten within weeks.
- Keep a symptom diary. Record headaches, memory lapses, mood changes, sleep and any difficulty at work or at home. It provides a record that memory alone cannot.
- Ask a close relative to write down the changes they have noticed. Their account is often more revealing than the injured person’s own.
- Follow medical advice on rest and returning to work. Going back to full duties too soon can slow recovery.
- Speak to a solicitor before accepting any offer or signing any document from your employer or their insurer.
How a brain injury claim differs from other injury claims
A broken wrist heals on a fairly predictable timetable. A brain injury does not, and that shapes the claim in several ways.
The prognosis takes time to establish. Recovery from a brain injury can continue for a year or two, so it is often too early to value the claim in the first few months. Medical evidence may come from a neurologist, a neuropsychologist who tests memory, processing speed and decision-making, and sometimes a neuropsychiatrist or an eye or hearing specialist.
Treatment can start before the claim ends. Once the insurer has been notified, a solicitor can ask it to fund rehabilitation such as physiotherapy, psychological support or occupational therapy under the Rehabilitation Code. Interim payments can also be sought once liability is admitted, which helps where the worker is off work and income has dropped.
Settling early carries real risk. Settlements are normally final. If new symptoms or a poorer recovery emerge after the claim has closed, it cannot be reopened.
Capacity may need to be considered. Where the injury affects a person’s ability to understand and manage their own claim, a litigation friend, often a close relative, can act on their behalf.
What compensation can cover
Compensation is made up of two parts. General damages reflect the pain, suffering and loss of enjoyment of life caused by the injury. They are assessed with reference to the Judicial College Guidelines, which set brackets by type and severity of injury. For brain injury those brackets stretch from modest figures for a minor injury with a full recovery to well into six figures for severe, permanent damage.
Special damages cover the financial losses that follow:
- Lost earnings to date and any reduction in future earning capacity or pension
- The cost of treatment, therapy and medication
- Care and assistance, including help given by family members
- Adaptations to the home, equipment and transport
- Travel to appointments and other out-of-pocket expenses
Where a worker cannot return to their previous job, future loss of earnings is often the largest element. Cases involving long-term care, permanent cognitive change or a loss of independence are treated as serious injury claims and usually need a far more detailed assessment of future needs.
What the employer pays during absence is a separate question from compensation, and our guide on whether you get full pay if injured at work explains where sick pay fits in.
Time limits
The general rule is that a personal injury claim must be started within three years of the accident. The clock can instead run from the “date of knowledge”, which is when the person first knew that the injury was significant and linked to the accident. That matters in brain injury cases, where the full effect can take time to emerge.
Where a person lacks mental capacity because of their injury, the three years does not start to run for as long as that lack of capacity continues. For a child injured at work, the three years runs from their eighteenth birthday. These are exceptions rather than a safety net. Witnesses forget, footage is wiped and records are lost, so claims are far easier to prove when they are started early.
Talking to a solicitor
If you or a member of your family has suffered a head injury at work and are unsure whether the employer was at fault, Marley Solicitors can go through what happened, explain whether there are grounds to claim and set out what the process would involve. A conversation at an early stage is usually worth having, even if symptoms are still developing.