PTSD and Mental-Health Injuries After a Crash: They Count, and Here Is How to Prove Them

Published February 15, 2024 · Injury Law Basics

Your arm has healed. The bruises are gone. But your heart pounds every time a truck fills the rearview mirror, you take the long way to avoid the intersection where it happened, and you wake at 3 a.m. hearing the sound of the impact.

That is not weakness, and it is not "all in your head" in the dismissive way an insurance adjuster may imply. Post-traumatic stress, anxiety, depression, sleep disruption and a new fear of driving are real injuries. Ohio law treats them as compensable harm. The challenge is that they are the injuries most often left out of the medical records, and in an injury claim, what is not documented tends not to be paid.

What mental-health injuries look like after a crash

Every person responds differently, but the symptoms we hear about most from clients after a serious collision include:

• Intrusive memories: flashbacks, nightmares, replaying the crash.
• Avoidance: refusing to drive, avoiding a certain road, panicking as a passenger.
• Hyper-alertness: startling at horns or braking, feeling constantly on guard.
• Mood changes: irritability, sadness, withdrawing from family and friends.
• Sleep and concentration problems, which affect work and home life.

Some of these overlap with the effects of a concussion, which is one reason a full medical evaluation matters. We covered that overlap in our post on documenting concussion and TBI symptoms. Only a qualified professional can diagnose post-traumatic stress disorder, but you do not need a formal diagnosis before telling your doctor what you are experiencing.

How Ohio law values these injuries

Ohio divides compensatory damages into two categories under R.C. 2315.18.

Economic loss, defined in R.C. 2315.18(A)(2), includes lost wages and medical expenses. Counseling sessions, psychiatric visits, medication, and time missed from work because of panic attacks or depression are all economic losses. Under R.C. 2315.18(B)(1), economic loss is not capped.

Noneconomic loss, defined in R.C. 2315.18(A)(4), expressly includes "mental anguish" along with pain and suffering and other intangible losses. This is where the human cost of post-traumatic stress is measured.

Noneconomic damages are capped in most Ohio injury cases. Under R.C. 2315.18(B)(2), the cap is the greater of $250,000 or three times economic loss, up to $350,000 per plaintiff and $500,000 per occurrence. The exceptions in R.C. 2315.18(B)(3), which remove the cap entirely, require a permanent and substantial physical deformity, loss of use of a limb or bodily organ system, or a permanent physical functional injury. A purely emotional injury does not lift the cap by itself, though a person with a catastrophic physical injury who also suffers severe psychological harm may recover for both without the limit.

Two practical consequences follow:

1. Treatment costs raise the ceiling. Because the cap can rise to three times economic loss, documented counseling, medication and lost-wage expenses do double duty: they are recoverable themselves, and they can raise the maximum available for noneconomic harm.
2. Mental anguish is often the largest part of a case. For many people whose physical injuries heal within months, the lasting harm is psychological. If it is not proven, it is not valued.

Our guide chapter on what your case is worth walks through the cap, its exceptions, and the factors that drive value.

How to prove an invisible injury

Insurance adjusters discount what they cannot see. The answer is a record that shows the injury as clearly as an x-ray shows a fracture.

Tell your doctor early, and keep telling them

The first medical visits after a crash usually focus on bones and bleeding. Mention the nightmares, the fear of driving, and the trouble sleeping at your follow-up appointments, too. A note in your primary-care chart that says "patient reports anxiety while driving since crash" is evidence. Our guide chapter on focusing on treatment first has a section on why mental-health symptoms count and how to get them into the record.

Ask for a referral, and follow through

If symptoms last more than a few weeks, ask for a referral to a counselor, psychologist or psychiatrist. A treating mental-health professional's records and testimony are usually the strongest proof of a diagnosis, its cause, and the outlook. Attend the sessions. Gaps in treatment are the first thing an adjuster points to.

Keep a journal

Write down, briefly, what you avoided, how you slept, and what you could not do. A dated, contemporaneous record of daily life is more persuasive than recollection a year later.

Let your family speak

The people who live with you see the change. A spouse who now drives you everywhere, or a child who notices you no longer go to their games because of the drive, can describe the injury in a way no chart can.

The privacy trade-off

There is a cost to claiming emotional injuries, and you should understand it before you make the claim.

Ohio's physician-patient privilege is waived when you file a civil action, under R.C. 2317.02(B)(1)(a)(iii), but only for communications that relate causally or historically to the physical or mental injuries at issue in the case, under R.C. 2317.02(B)(3)(a). When you put your mental health at issue, past counseling and psychiatric records can become fair game.

We wrote about this in 2022 in our post on medical privacy after Bokma v. Raglin. In that Montgomery County case, 2022-Ohio-960 (2d Dist.), the injured driver's complaint alleged pain and suffering "both physical and emotional," and the Second District held that this waived the privilege for her psychological records as well as her physical ones; the insurer had sought records going back ten years.

That does not mean you should hide a real injury. It means the decision about what to claim, and how to describe it, should be made deliberately, with a lawyer who has reviewed your history, rather than in a complaint drafted from a form or a conversation with an adjuster.

What this means for you

• Your emotional injuries are real and compensable under Ohio law.
• Report symptoms to your doctor and get a referral if they persist.
• Keep a short journal and keep your appointments.
• Do not discuss your mental health with the other driver's insurer, and do not sign broad medical authorizations. Our guide chapter on mistakes that hurt your case explains why blanket authorizations are a problem.
• Talk to a lawyer before deciding how emotional injuries will be presented.