A Looooong Love Letter from Me to You
I haven't written anything since August. I've been absorbed with tasks. Anyone with a brain injury knows how difficult and distracting tasks can be. Before I knew it nearly 4 months has passed. I try not to stress about it but it's difficult. I want to write. I have so much information to pass along, experiences to share, topics to discuss, questions to ask all of you.
This topic has been following me around for months now. It's motivated by the posts I read often on the Facebook TBI support groups. Women, men telling their stories, sharing their struggles in dealing with insurance, attorneys, disability, work, relationships, etc, etc.
Some of the stories haunt me.
I've been a problem-solver all my life. It definitely originates from a naturally curious mind and nurtured by the need to survive a terrible mother. Sometimes high level skill sets develop from the most unexpected and unpleasant circumstances.
I'm certain I'm not alone in this.
It's no wonder that I ended up working "by chance" as a risk analyst /business consultant for high profile organizations. I was good at it too until my TBI took my career away from me.(Note....No one will toot a horn for you, you gotta do it for yourself.) Problem solving and helping others was the bedrock of my work.
My work involved understanding everything about a company. Who runs it? What do they do, what are the risks involved with what they do to people, their employees, the planet? Where do they do it, make it, sell it? How do they do what they make, sell or do? And when do they do it? The list goes on and on.
If you think proctologists take deep lives, guess again.
Risk analysts dive a hell of a lot deeper.
The goal was to design insurance contracts that protect an organization's property, its intellectual property and its people to the best of our ability, while making some money too. This ain't no "State Farm" insurance situation. This is sophisticated, complex, nuanced, detailed work that requires a high business acumen and people skills. Contrary to what some say, corporations are not people. People want to protect their "stuff". And that "stuff" matters to them.....their employees, their products and services, their reputation, their property, etc. etc. Why? Because they worked hard to make that business a reality and they don't want to lose it. No matter the size of the business.
Good insurance companies pay claims. They look for ways to pay claims, not deny them. I worked for that kind of company, not the shitty ones who deny everything. Those companies are run by particularly evil people. I hope Karma gets them and it's a long, painful ride into hell. They deserve nothing less.
So here I sit nearly every morning, reading a post from one of my fellow TBI survivors and feeling helpless to fix her/his problem. I do admit I do believe there is a solution to every problem and somehow I can help. It's not a "know it all" thing but a "help" impulse.
Now, I certainly don't know the solution to everything. Jesus, what a mess that would be. I do offer my perspective when I feel it's relevant when other's share their struggles in those Facebook support groups. But I want to do more. That's what sparked the whole idea for this blog. I want to help others. I want to share the things I've learned in my TBI recovery. And I want to learn from anyone reading this blog. I want people to reach out to me and share what they're experiencing; what works, what doesn't. Just like you can't ever have too much insurance, I believe there's no such thing as having too much knowledge. Plus it keeps me from screaming my head off daily at the frustrations of the world. Channeling energy constructively is a good thing.
So, I've been thinking....What can I share that provides real help others can use now? Right now? What knowledge is really important to a TBI survivor in support of her/his recovery?
Insurance, dummy. (Me, not you)
Don't roll your eyes or make gagging noises. This shit is important.
Having quality, adequate insurance and understanding the who, what, where, when and how's of insurance are very important to a TBI survivor. For anyone needing to make a claim. TBI survivors particularly need support immediately. Not yesterday, now. We don't have the capacity to try to figure all this crap out on our own. That's what too many insurance companies love. Ignorance.
What you don't know, will cost you. Money. Time. Suffering. And more Money.
So, I'm going to share some of my knowledge gleaned from a 25 year insurance career. It's my way to sending love and support out "there" to whomever may benefit from it.
I'm gonna try to keep this as simply as possible. Your particular circumstances and the state you live in (in the USA) will play a notable part in how this information will apply to you, so keep that in mind. If you live outside the US, it's best you seek advice from an attorney.
You've survived a TBI.
Have you seen a doctor?
You need to see a specialist. You need to see a neurologist and you likely need to have a CAT scan and an MRI to rule out any visual damage to your brain. So much of a TBI determination and treatment is about evaluating symptoms. Most don't have visible damage that shows up in those two common scans. But you're going to need those tests for insurance purposes to establish a diagnosis for the insurance company that your injury is or maybe in the coming months, a serious matter.
Just do it. Even if you think it won't show anything now (most don't in the case of "mild TBI") or you don't feel you have much in the way of symptoms. You need to establish a relationship with a brain specialist. And you need that if/when your symptoms begin to materialize or worsen.
Do you need time off work due to your TBI?
This applies whether you were injured at work or not.
Short Term Disability
If so, you need to see if your employer provides short term disability coverage. Talk to your company's Human Resources manager. This is insurance that pays your wages for a specified period of time while you are recovering. Sometimes an employer has a requirement that you have to be off work 3 to 4 days due to your injury before you can submit a request for short term disability and it starts to pay your wages. Usually you have to take sick days for those initial 3 to 4 days off. This is where you need to have been evaluated by a doctor. A specialist such as a neurologist, is a good choice. If you can't see a specialist right away, then the ER doctor or your primary care physician you initially saw, will do. That doctor will do a write up stating that she/he wants you off work for a specific amount of time. Then that doctor will have you in for follow up visits to monitor your condition and re-evaluate if you need more time off, etc. (Hopefully you've been able to get scheduled with a specialist by this point to take over your care management.) That information will have to be supplied to the short term disability insurance company. This company is a provider, not a part of the company you work for.
It's a good idea to have someone at home helping you with the paperwork, keeping track of interactions with the short term disability company, HR, your manager, etc. You will want to keep your manager updated on your status too.
Be mindful here, do not tell your employer too much detail about your condition at this point. Depending upon the employer, this can come back to haunt you. Keep to the basics and you'll be fine.
So what's next when the Short Term Disability runs out?
Long Term Disability and all that comes with it.
Long Term Disability is an optional coverage that most employers offer their employees. You'll see the options included in your employer's annual healthcare benefits offering.
Employers typically have employees make their healthcare selections every fall to be in effect the upcoming new year.
Now I hope you selected Long Term Disability coverage. And I hope you selected the most coverage offered. There are typically options that will cover 60, 70 or 80% of your monthly wages.
Let me state this strongly:
LONG TERM DISABILITY IS CHEAP!!!!!! BUY THE HIGHEST PERCENTAGE AVAILABLE!!! It's a catastrophic coverage.
That means you can purchase that coverage through your employer for years and never use it. Or you could have paid/signed up for the coverage for a month, a year or 20 years and then it's there when something happens to you and you can't work.
If you have it, thank God. If you don't, well...then I hope your TBI happened due to someone else's negligence. You need a wallet to go after now. And you need a good, aggressive attorney to get you money asap.
If your spouse/partner doesn't have the coverage, get her/him signed up at the max percentage available. Long term disability coverage is not the coverage to skimp on.
It's what's known as a "sleep at night" insurance. You can sleep at night knowing that there is coverage to pay your wages.
Long Term Disability kicks in when short term disability ends, usually around 90 days. You have to submit a claim for the long term disability coverage. Your human resources manager should be able to help with this. Be sure to do it before your short term disability period ends, to minimize any disruptions in receiving your pay. It's usually a smooth process but there's an exception to everything.
You, of course will still be under a doctor's care and your doctor doesn't want you going back to work yet. This is where seeing a neurologist, a cognitive therapist, a neuropsychologist - any brain specialist that your condition demands, is important. You will need to provide the insurance company with regular updates. Your doctors will need to provide regular updates. See all of your TBI related doctors regularly. Be prompt with any information that the insurance company requests from you. If you aren't prompt, they will stop/delay payment. You don't need that headache. Have a family member, a friend, anyone who helps support and care for you to assist with all of this. By nature I am a note taker and I document everything (a byproduct of my work). I strongly recommend getting an 8 x10 calendar with note pages for each day of the month. Search for it on Amazon - they have tons of options.
Here's a link to one that works for me:
( I don't get anything for mentioning this calendar. It's just a reference item to see if something like this will work for you.)
DOCUMENT EVERYTHING in your calendar. Take notes at all of your appointments Not after. AT THE APPOINTMENT. Every day write down your symptoms in it. It doesn't have to be a long diary entry, just brief notes of what you are experiencing, daily tasks you have problems with, eating issues, balance, sights, sounds, stimulation, memory, rage, anxiety - all of it. This is extremely helpful when sharing your symptoms with your doctors. TBI almost always comes with memory issues of some kind. No matter how great at remembering you think you are, you're not right now. DOCUMENT EVERYTHING. That calendar should become your TBI bible. Take it to every appointment. This calendar will serve as your memory and be a great resource should you have any issues with the insurance company.
Disability insurance companies are only decent for a certain frame of time. Once you start getting close to around 12 months off of work, they are going to start to get nervous that you will be diagnosed with a permanent disability due to your TBI.
That's when they start to get shitty.
This is when you have your team of doctors/therapists who are supportive of your recovery and are your advocates. Any crappy, insensitive healthcare providers should have been disposed of a long time ago. If not, get rid of them now. Get better, TBI experienced medical professionals.
The Neuropsychological Exam
At around 8 to 12 months the disability company may want you to get a neuropsychological exam.
Here's a great overview of what a neuropsychological exam is, does, what to expect, how it should be interpreted, etc.
There's one statement within the Cleveland Clinic's explanation that I think is very important to point out.....here's the sentence to pay particular attention to:
"The tests are also norm-referenced, which means that a patient’s performance on those tests will be compared to the performance of other people who are about the same age and, sometimes, people who have the same educational background."
"And, sometimes,...." is a BIG deal. The neuropsychologist ABSOLUTELY should be comparing your results with other people of a similar educational background. This matters.
If you're really freaking smart, your work is demanding, your work is specialized, you went to college, then on for a Masters or a PhD, you should not be compared to a prison inmate with a 5th grade education who is the same age.
Even if you are all of the above (not the prison inmate) and didn't go to college, a quality, experienced neuropsychologist should be taking your life/work abilities into account when completing the evaluation. There is some gray in these evaluations. A good neuropsychologist knows this and acknowledges it with science supported methods.
This is also why you need to see a neuropsychologist who doesn't spend most of her/his time testing prison inmates or other primarily low functioning persons. I'm serious with this one. Very. The first neuropsychologist I was referred to was a guy that is well known where I live and well regarded.
I knew nothing about neuropsychologists and these exams at that time. I had no capacity to figure out what made a good neuropsychologist. I just depended upon my cognitive therapist for a local recommendation.
What a freaking mess.
Turns out the doctor, who was ancient and looked like he took hygiene advice from Pig Pen from the Peanuts - spent most of his career evaluating prison inmates.
My husband and I were looking at each other like "WTF?" when we left his office after the first visit. But we didn't know any better and set up my evaluation for the following week. It's just a standardized test, right? Wrong.
I came back and upon entering the office, the "evaluator", not the doctor, was screaming like a lunatic at another patient. She looked at me, paused and then continued screaming at the other patient. That patient was just standing there, doing nothing that could warrant such treatment.
Now, I got triggered. Since my accident I don't deal well around over-stimulated (and most especially angry) people. Four years ago....I really didn't have much impulse control. My fight or flight management response has been damaged. My poor brain.......
I screamed at her "Shut the FUCK UP! Stop Screaming!" Yeah, that was helpful. It just came out without any filter. When filters are damaged, it applies to what comes in and out.
Then I called her a crazy bitch and that I would never allow her to evaluate me because she's a crazy bitch.....and left.
I called the doctor from the parking lot, got his voicemail and left him a detailed message about what happened. I never heard from him. Ever.
I went back to my cognitive therapist and told her what happened. She thought the whole "Shut the F-up" stuff was kind of funny. I didn't. And I wasn't happy that she referred me to that doctor. Prison inmates? Seriously?
She made up for it by finding me the best doctor I could have ever hoped for. She's been my lifesaver. Without Dr. Ryan, my neuropsychologist, I would not have made it through my long term disability battle, let alone be in the place of my recovery that I am now. I've still have a lot of challenges but without her, I honestly don't know where I would be.
I might have given up and not be here. I have been in that dark place in my recovery journey.
A good, qualified doctor who gives a damn is essential. Find one.
When a TBI survivor can not return to full time work at 18 months, she/he is considered permanently disabled by standard medical guidelines. This is where the disability insurance company has likely tried to stop paying benefits.
They do not want to pay your monthly benefit until you are 65 and they will likely have been playing dirty by now.
Do not have your 1st neuropsychological exam performed by one of their doctors. Your first test should be completed by a doctor of your choosing. I can not stress this enough.
Just like with workers compensation doctors, a doctor hired by a disability insurance company is on the insurance companies payroll and will NOT be impartial. Ever.
A neuropsychological exam may not be covered by your insurance. You will have to check. They may require a referral. You can get one from your neurologist.
If the exam isn't covered, I really want you to find a way to find the money to pay for it. It's around $2,000. I know this is a lot of money. But this is important. It will be the difference between getting the financial benefit to help support you until retirement age and struggling to survive like no one should have to.
You need an impartial evaluation by a knowledgeable, supportive doctor, not an insurance company whore gunning to take you down.
That exam can change the direction of your benefits. You deserve to be paid if you're disabled. You don't deserve to struggle. Think of it as an investment that will pay for itself and ensure you are paid for years to come. Paying out $2,000 or so now is a lot less expensive than losing, for example: a $1,000 monthly benefit until you're 65.
That's $1,000 x12 months = $12,000 per year.
Say you're 40. So you should be paid $12,000 a year for 25 years...that equals $300,000.
I'm thinking that $2,000 for the exam is looking really small right now.
Do some of the work now, get help in doing it, and take it one step at a time. You can do this. Don't give up.
You may still have to do a neuro-psych exam with one of the disability insurance company's doctors. You'll likely have to cooperate with this but you may not depending on the time frame from when you had one completed by your doctor. There is a guideline set for when neuro-psych exams are warranted. Your neuropsychologist will know this. The insurance company doctor may have to just use your doctor's evaluation information to make his/her own assessment. Know this, the insurance company doctor is going to say you have some sort of mental health issue, menopause, anxiety issue....anything but a brain injury that has fully disabled you and you are unable to return to your work. It's just not going to happen. They don't want to payout that monthly benefit until you are 65.
The insurance company is not your friend.
The Long Term Disability Appeal
This is where the disability insurance company sends you a benefits denial letter. They've been paying your benefits for about 12 months or so and now they've determined something else is wrong with you. Not the TBI.
You have the right to appeal their decision.
DO NOT do the appeal yourself. I'm serious. Do not do it. You will never win your appeal if you attempt it on your own.
The disability insurance company will send you appeal information and an appeal form, along with their denial letter. That appeal information and form will look like it's easy enough to fill out and send back and win your appeal.
NOT. It's a poison apple. Do not take a bite.
The insurance company wants to prey upon your ignorance once again.
Disability benefits fall under Federal Law and are subject to rules that apply at that level, not at your particular state level.
The insurance company doesn't want you to know how important it is to provide as much detail as possible, in writing, about your TBI and every little way it has impacted your ability to return to work, to live safely, and independently.
Why is it important? Because if the insurance company denies your appeal (doesn't agree you truly are fully disabled and unable to return to work), then you have a right to file suit. The case can then become what is called a "paper trial". That means all the information you supplied on that little appeal form gets sent to a federal judge to review and rule upon.
Now....how much documentation do you think the insurance company is going to provide to that judge versus how much you supplied with that one or two page form letter you completed with your appeal?
Yeah. That scale is definitely weighted heavily to one side and it's not yours. How could the judge possibly have a full picture of your injury from one or two pages?
This is another situation where you must have an expert. If you've been denied long term disability benefits by your insurance provider, you need a good attorney who specializes in suing insurance companies for disability benefits.
Note this......it's also important to understand that you can hire an attorney to represent you in your disability insurance benefits appeal from any state in the country.
Remember when I said disability insurance is governed by Federal law? Well, that also means that you're not stuck with finding a good attorney in your state.
I worked with some of the best law firms in the country during my career. The Big Guns located in California. When my accident occurred, I was living in Denver, Colorado....not a bad area of the country when you need to find a good attorney. Then I moved to Santa Fe, NM about 4 months after my accident. 8 months later, I was in need of an attorney to fight for my disability benefits, but I'm living in New Mexico now. The Land of Enchantment is not the "Land of Excellent Medical Care and Disability Attorneys".
We couldn't find anyone local who was competent, to fight for me. Somehow my brain remembered (because this was part of my previous work life) that I could hire an attorney from any state. I wasn't locked into an attorney from New Mexico. Thank God! Otherwise, I would have been screwed. I needed an experienced disability attorney who understood the "game" and how to win.
I found a great one out of New Jersey. Top notch. He has a tried and successful strategy to address the appeal and set it up so that if the insurance company didn't concede, we would win if it went to the "paper trial" with the federal judge.
He provided my disability provider with over 300 pages of explanation and documentation on every complex and simply item that was impacted by and related to my TBI. Everything you could possibly think of was addressed with mountains of written documentation. I didn't have to do anything except provide some relatively easy information, connect him with my doctors and wait. My husband, of course, managed most of the process but it was still exceptionally easy. And we won.
Again, this is an area where you need to weigh the cost against what you are at risk of losing. This is about financial support for the rest of your life. If you can find a way, pay an attorney to represent you and handle the appeal for you.
After your appeal is completed and you've won....either by the insurance company conceding or the "paper trial" federal judge finds in your favor......you're set.
For 12 months.
Every 12 months the disability insurance company is going to send you a letter asking for a written update on your condition. They'll want a lot of what they've asked for in the past updates. I suggest keeping things simple. Include what you've shared in the past, add comments on any new issues. They will want your doctor(s) to send an update. Call your doctor(s) and ask him/her to complete the brief form by the required date so you can have the information returned promptly. The doctor you see routinely for your TBI issues is the one to complete this form. Have that doctor return the form to you and you send it back to the insurance company. Control this. That way you know the information was actually supplied and when. Send it to the insurance company by fax or email and via registered mail to ensure they can't say they didn't get it. They will stop payment of your benefits for any excuse. Remember, you need to remain under a doctor's care in order to maintain your disability benefits.
So, damn.....Liz. This post is freaking long, how much more can there be? Yes, I know. It's a lot. My brain has been exhausted writing this for weeks. But it must be done. All this stuff ties together. I think if I don't provide it all in one post, the information will be piece meal and more difficult to find later.
This insurance information has to be all together for easy reference because depending on your situation one or all of this could relate to you. Book mark it, print it, save it to your computer. Whatever you need to do to come back to this information, when you need it, is all good.
Social Security is next. Yuck.
Who the hell ever thinks she's going to apply for Social Security before retirement?
But if you've been disabled due to your TBI - one way or another, you'll be in the position to apply for Social Security Disability Insurance (SSDI).
If you have long term disability coverage, then it's highly likely the insurance company will require you to apply for SSDI. Why? Because if you are granted SSDI, they will deduct the amount SSDI pays you from the amount they are originally obligated to pay you. For example, if disability insurance pays you $2,000 a month and SSDI grants you $750 per month, then the disability insurance company will deduct the $750 from the original $2,000 and now send you $1,250 per month.
The disability insurance company will usually hire an attorney to handle the filing for benefits on your behalf, at no cost to you. Social Security will deny your application for benefits. They do this to everyone. Don't take it personally. Then you appeal. Well, rather the hired attorney will appeal for you. Social Security will then set a date for a hearing in front of a judge. It typically takes around 10-12 months to get the hearing set. Sometimes less.
When the time comes, you and the attorney and hopefully your spouse, significant other, primary caregiver go to the hearing. Take one of your caregivers with you. It will matter to the impression the judge forms of your situation. The hearing is informal. If it is like mine was, it's in some crappy government office meeting room with smelly carpet and beige walls. And I was fortunate. I had a judge who had been a white collar disability attorney for most of his career. He understood the challenges I was dealing with. He had fought for clients like me. He asked my husband what concerned him most day to day about my condition. My husband told him it was my rage issues. He was constantly concerned he was going to get a call at work telling him I had been arrested for assault while grocery shopping. I just started to cry in shame. The judge ordered in my favor as fully disabled. The judge stated my doctor's neuropsychological exam made a huge impact on his decision.
A side note: My SSDI was awarded months in advance of my disability insurance provider denying my benefits. That means Social Security had ruled I was fully disabled, yet about 6 months later my long term disability insurance benefits were cut off and denied for permanent payment, stating I wasn't fully disabled.
Yup. You read that correctly. Even though Social Security found I was fully disabled, which is akin to winning the lottery, the long term disability insurance company decided I wasn't.
WTF? Yup. That's the game that they play.
They try to rattle you. Get you to give up. Don't. It's a game. You just have to remember that. Keeping fighting back.
If you don't have long term disability insurance, you can still apply for SSDI. The process is laid out on the Social Security Administration website, here: https://www.ssa.gov/benefits/disability/
You can do it yourself or hire an attorney. Again, weigh the value of the benefit of an attorney. As I understand it, lots of people do it both ways. Not everyone has the money to hire attorneys for everything. If you don't, then it's important to have an advocate who has serious organizational skills and knows how to follow directions exactly....and tolerate dealing with the government, to help you with it.
The good news is that once you've been awarded Social Security Disability payments, you don't have to keep re-documenting it every year as you do with a long term disability insurance company. You may get an occasional letter from SSDI asking if you want to go back to work and some information on how to do that. If you're in a place to do that, do what is best for you. Otherwise, if your recovery hasn't provided you with enough to go back to work, that's okay.
So we've covered Short Term Disability , Long Term Disability and Social Security Disability Insurance.
Injury Caused by Someone's Negligence
What happens if you were injured due to an accident caused by someone else?
A car accident. Someone ran into you while riding a bicycle. Someone attacks you in a restaurant. Someone hit you in the head with a baseball after throwing a temper tantrum at a softball game.
YGABA You. Get. A. Badass. Attorney.
Not just any attorney who has a billboard boasting about how much he/she cares about you. You need to interview attorneys who have extensive experience with catastrophic long term injury cases. Ask specifically if she/he has represented clients with traumatic brain injuries. If not, ask her/him what they know about head trauma....the challenges, complexity of injury, one size does not fit all, long term needs versus short term, the recovery roller coaster and changes in manifestation of symptoms, the emotional challenges, memory issues, etc, etc, etc.
That attorney needs to be willing to "get it". To take the time to understand, otherwise she/he can't fight hard enough with enough information to substantiate your claim. In other words, get you the money you deserve.
If someone else caused your injury, you hopefully have obtained that person's insurance information.....typically in the case of an auto accident.
All your medical bills should be sent to the offender's insurance company. Most people buy medical pay limits under the auto insurance policy that covers medical bills for the injured person. The limit is usually $5,000 or $10,000. That's the amount they will cover for your bills, if the other guy is at fault. But then there is also the Liability insurance limit provided under the at-fault person's policy that can be tapped into later. Do not have your health insurance pay the bills unless absolutely necessary. Do not have the bills to repair or replace your car paid by your insurance company, if the other guy is at fault.
The sooner you can send the bills to the other guy, the better. It's less headache for you.
Usually the hospital or your local doctor will ask if your injury was due to an accident. Don't hesitate to give the offender's information to them.
Most states allow up to 24 months from the date of the accident to file suit against the responsible person(s). Find out what the law is in your state. Don't wait too long. But do give yourself time ....12-14 months to understand the complexity of your symptoms and the level of your recovery is reasonable. What the permanent impact to your life has been? Your attorney will need that information to target a settlement amount. By then you will likely have a great deal of documentation from doctors, etc to support your case. Finally do not settle with the insurance company without consulting an attorney. Insurance companies love this. You can ask an attorney upfront how much she/he thinks your case is worth. Then you can decide to hire an attorney or not. Typically those with attorneys get more money. When an injury case is traumatic, you can negotiate for your attorney costs to be paid in addition to your payout. Some states may limit this or deny it, but don't forget to ask about it.
Be patient during the process. Remember, just like with insurance, suing someone for liability is a game, a process. If you've hired a good attorney, that person will not need to be micro-managed. Let the demon off the leash and you go rest and focus on your recovery. Do keep tabs on the demon, though. It's never good to let one run around unchecked.
Work related Accident
It doesn't matter if you're a construction worker who falls off scaffolding or a big wig manager going for a pee and you slip and fall leaving the bathroom.
The very lucky have an employer who truly cares when an employee gets injured and wants to help as much as possible to help that employee recover and return to her/his work and life as quickly as possible.
Getting hurt at work is it's own level of hell.
Unfortunately, too many employers look upon injured employees as con artists and shysters looking for an easy buck, a free ride. It's ridiculous. Most injured employees do not try to milk the workers compensation system. Employees want to recover and get back to work. There are plenty of work place environments that treat employees like they are disposable. That's, in my opinion, where one finds employees trying to stick it to the "company". And can you blame them, right or wrong?
It's a case of you get what you give. You're a shitty employer, you get employees seeking to feed you shit. It is what it is.
If you've had a TBI (or any injury) at work, there is a process that you will need to go through, required by law in the state you work in. In the case of a TBI, it's likely you don't have to report it to HR immediately because you were probably taken to the ER by ambulance or it was very clear you were injured at work. In any case, your injury needs to be reported to HR in writing. Do it in writing, as some states allow for verbal notification where others require it in writing. Email works just fine for this.
This website provides good information on what to do if you are injured at work - its worth the read:
The link above addresses most of what you need to know about dealing with worker's compensation.
However, there are some other things you should know:
1) At some point your employer, manager, co-workers may not treat you well. They may treat you like you are faking, lying, exaggerating. Too often the challenges and symptoms associated with TBI are not "seen", so it's easy for others to put aside the good person they know you to be and decide you're now a liar and a freeloader. It's like they think you're getting something they aren't. It's sick and it's undeserved. Be prepared as best you can.
2) The details of your injury and your work related accident is no one's business but yours. Your employer for the purposes of managing your work comp case, does have the right to access your injury related medical records. Here's a link that specifically explains the HIPPA law and how it applies to workers compensation: https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/disclosures-workers-compensation/index.html
Typically an employer will want you to keep HR updated on your case and keep in touch with your manager if you are off work due to your injury or if you need work changes to accommodate your injury. If you have a good employer, they will treat the matter respectfully and be helpful. If they are not, it's best to be as minimal with sharing details with co-workers and managers as possible. They will try to use what you say against you. Be mindful of this.
3) You may need to sue your employer for an unsafe work environment or negligence in order to receive the benefits needed to support your ongoing TBI recovery. With any serious work place related injury, I would recommend talking to an attorney. Do this discretely. Do not confide in your best buddy at work. Suing your employer is a hostile act and they will see it that way. But what's important is that you protect yourself, your rights to be provided the benefits you are entitled to under your state's laws and to a peaceful recovery.
I know all of the information I've shared here is A LOT to absorb. It's awful to have to fight for what should simply be given to us when we're recovering from something so serious as a head injury. Corporate insurance was my career and I still had to deal with too much crap.
Unfortunately, it is what it is, in our society. Money first. People second. I do believe if you set your mind to taking really good care of yourself throughout your recovery with lots of support, the stress of all of these possible challenges will be reduced.
See supportive, TBI experienced doctors and therapists only, as soon as possible. Your primary care doctor will not be enough to manage your recovery. Recovery takes a village of doctors and therapists willing to help. You will need this village to support your challenges in dealing with the insurance companies and your employer.
Get at least one person willing to help you with all of your documentation and insurance and attorney matters and doctor visits. That person needs to be in it for the long haul.
Use a monthly calendar. Document everything. Appointments, symptoms, stressors, things doctors tell you, the insurance company tells you, etc.
Breathe. Take one step at a time. You can do this. And it can work out well for you.
If you need an attorney, do the homework needed to get a good one. Look at the long term benefit of hiring an attorney versus the short term financial stress of paying one. You're investing in your quality of life for the long term.