Concussions increasingly make today’s news headlines, especially in athletes playing contact sports like football. But concussions don’t only happen on the field — they are being reported more often in the workplace, too. And they can be complex and costly to treat.

What is a concussion?

A concussion is a traumatic brain injury caused by a blow to the head or whiplash that results in the head and brain moving 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,” according to the Centers for Disease Control and Prevention .

How serious are concussions when compared with other work-related injuries?

In 2016, 78 percent of SFM’s concussion claims involved lost time from work, compared with 15 percent for non-concussion claims.

Because the duration, symptoms, diagnostic testing and treatment in each case are so varied, concussions can be very complex and costly to treat.

Are there more concussion injuries now than in the past?

In Minnesota, the number of lost-time claims with concussions increased to its highest level in 2018, according to the Minnesota Department of Labor and Industry's COMPACT newsletter . The number of workers with concussions who receive wage loss benefits due to time off work is now 10 times higher than the number in 2006, according to the newsletter. The increase could be due to heightened awareness of concussions among employers and employees.

What are the symptoms of a concussion?

Physical symptoms of concussions may include:

• Headaches
• Nausea
• Vomiting
• Balance and visual problems
• Dizziness
• Fatigue
• Sensitivity to noise and light
• Tingling and numbness
• Ringing in the ears

Workers may report:

• Feeling mentally foggy or slowed down
• Having difficulty concentrating
• Being forgetful or confused

Those suffering from concussions might answer questions slowly or repeat questions. They may be irritable, sad, nervous or more emotional than normal. They may be drowsy, sleep more or less than usual, or have trouble falling asleep.

How long does it take to recover from a concussion?

Most cognitive issues related to mild concussions resolve within 7-10 days and go away completely after three months. However, 10-15 percent of sufferers experience longer-lasting symptoms, often referred to as post-concussion syndrome.

How do I accommodate an employee who has had a concussion?

Since a concussion isn’t a visible injury, employees might seem ready to return to regular work when they really aren’t. It’s important to respect any work restrictions. This could mean offering a shortened work day, breaks or fewer tasks and responsibilities.

The injured employee may be encouraged to rest and may initially need to reduce physical and cognitive exertion. In some cases, reducing work during the initial stages of healing may help the employee’s recovery.

After the employee returns to work, the doctor may recommend the employee avoid driving, heavy lifting, working with machinery or working from heights for a period of time. It's helpful if you can provide a calm, quiet work area where the lighting can be lowered if needed. It can also be helpful to provide them with a place to rest.

Keep in mind that rehabilitation therapy is key during recovery and may include speech therapy, occupational therapy, physical therapy, or a combination of the three, from one to four days per week.

Realize that their thinking, speech and reaction times might be slowed, and they may be less able to concentrate. They probably won't be as productive as usual at first, and their job tasks may need to be altered. But incrementally over time, the employee should be able to return to normal work.

It’s important to take the condition seriously, but it’s also important to be positive and reassuring with the employee about their recovery. The injured employee may be in a vulnerable state — scared and upset by their symptoms and worried they might worsen in the future. The anxiety just makes their situation worse.

Thankfully, most cognitive symptoms clear within two weeks and most patients recover fully within three months.   

What are the common causes of concussions at work?

Concussions are often related to slips, trips and falls, strikes to the head, or motor vehicle accidents. Inanimate objects, such as falling boxes, might cause a strike to the head. In other cases students, patients or co-workers might strike an employee.

How can I prevent concussions among employees?

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

• Remove tripping hazards. Make sure walkways and workspaces are free of clutter, cords, puddles of water or anything else 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.

What should I do if an employee suffers a head injury?

If a head injury does occur, and you're an SFM policyholder, report the injury immediately and make sure the injured employee gets the proper care.

It’s crucial to get a thorough evaluation by a doctor who is trained to assess and treat concussions. Do not try to diagnose a concussion yourself.

For the best outcome, the employee should receive treatment from a provider who has experience with post-concussion syndrome.

If the employee is off work due to the injury, check in frequently to let them know you care about them and hope they feel better soon. Be kind and empathetic. 

You can also provide reassurance, as the employee might be suffering from any number of very concerning symptoms, and anxious that they'll never be the same again. You can reassure the employee that typically most symptoms resolve in a couple of weeks, and go away completely within three months. 

Try to bring the employee back to work as soon as possible after the employee's doctor will allow it. This might mean providing a transitional job, reduced hours or other accommodations. 

What are the challenges of managing a concussion claim?

Due to the wide range of symptoms, treating concussions can be complex. It can involve multiple specialists in the areas of neurology, orthopedics and psychiatry.

When a workers’ compensation claim involving a concussion becomes litigated, things get more complicated and costly. The cost of independent medical examinations alone can easily top $20,000, due to all of the different medical specialists needed. And because many symptoms of concussions are subjective, it can be challenging to independently verify the extent of the injury.

This is not intended to serve as legal advice for individual fact-specific legal cases or as a legal basis for your employment practices.