After a concussion, you may continue to suffer from headaches, fatigue, concentration problems or sensory overload. If someone else is liable for the accident, the resulting limitations and costs may form part of a personal injury claim. The absence of a visible abnormality on a scan does not automatically rule out a claim. However, the symptoms, their consequences and the link with the accident must be carefully substantiated.
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Written by Onur Arslan, attorney at Arslan Advocaten. Registered in the Netherlands Bar’s register of areas of practice for employment law and personal injury. Last updated: 17 September 2026.
A well-prepared file is particularly important when you can no longer work or study as you did before. The term mild brain injury says nothing about how mild the consequences feel to you. At the same time, a legal text cannot make a medical diagnosis or predict how long recovery will take. Below, you can read how the medical and legal assessments fit together.
In brief
- Persistent symptoms after a concussion can be compensated, even without an abnormality on a scan: a CT or MRI scan is not the means of proving these symptoms.
- What counts is a consistent timeline: symptoms reported shortly after the accident that recur throughout the file.
- Make concentration problems, sensory overload and fatigue concrete: which task, for how long, and what happened afterwards.
- The heads of damage are the concrete consequences: lost income and reintegration costs where a return to work proves difficult, the costs of delayed studies, and help with household tasks and with organising everyday matters. The return to work itself is not a head of damage, but the lost income and the related costs are.
- If your symptoms are permanent, read this article alongside, not instead of, our explanation of acquired brain injury.
Quick action list: what to do this week
This page is long. If you are reading it while struggling with concentration problems or sensory overload, these are the five things that matter now. You can read the rest later.
- Report your symptoms to your GP, even if a scan showed nothing. What is not in the file will, legally speaking, barely exist later on.
- Hold the liable party liable in writing, or have someone do this for you. You can do so before it is clear how large the loss will be.
- Keep a simple diary for one week (see the example further down). One week is enough to show a pattern; do not do it every day for months on end.
- Keep everything in one place: appointment letters, referrals, sick notes, receipts. One folder or one digital folder.
- Ask for an advance payment if costs are mounting. This does not have to close the case.
Do this at your own pace and spread it over several days. Overexerting yourself while organising your file will not help your recovery.
Medical assessment comes first with a head injury
After a fall or a blow to the head, a medical assessment may be necessary. If your symptoms are acute or getting worse, seek appropriate help in good time. The information from Thuisarts, the Dutch GPs’ patient information website, on a fall or blow to the head describes when you should contact a healthcare provider immediately. A compensation claim should never be a reason to delay medical help.
If your symptoms persist, discuss with your treating practitioner what needs to be investigated or treated. The course of recovery differs from person to person. Do not take a fixed recovery period from a website as a prediction for your own situation. Changes or new symptoms should also be discussed with a medical professional.
Keep relevant letters and overviews of appointments. For the personal injury case, what matters most is that the course of your symptoms and the advice you were given have been carefully recorded. You do not have to prove medically which processes are taking place in the brain yourself; that is what healthcare providers and, where necessary, experts are for.
What is meant by persistent symptoms
A concussion is generally classed as a mild traumatic brain injury. Some people recover without long-term consequences, while others continue to have symptoms. Various terms are used, including post-concussion symptoms. The precise medical interpretation must fit your file.
Symptoms may, for example, affect attention, energy levels or the ability to tolerate stimuli. This does not mean that every symptom after an accident is automatically explained by the concussion. A treating practitioner may also investigate other or additional factors. A complete picture is exactly what the claim requires.
This article focuses on the settlement of claims for persistent symptoms after a head injury. It is not a general description of all forms of acquired brain injury. With more serious brain injury or other diagnoses, other medical questions and support needs may be central.
No abnormality on a scan, yet still symptoms
A normal scan does not in every case mean that there cannot be a concussion or symptoms. The Dutch Brain Foundation (Hersenstichting) also describes mild traumatic brain injury without abnormalities on a CT scan. What a test result means in your situation must be assessed by a doctor.
For the legal claim, the absence of a finding on a scan is therefore not automatically decisive. The assessment looks at how the accident happened, the initial symptoms, the medical assessment, the subsequent course and the limitations. That overall picture can be more important than a single test result viewed in isolation.
Conversely, the mere statement that scans do not show everything does not in itself prove a causal link. Your specific symptoms must be investigated and substantiated. A carefully prepared file avoids both extremes: rejecting everything because of a normal scan, or attributing all problems to the accident without further assessment.
The timeline of the accident and the symptoms
Draw up an overview of the event and the period that followed. Note when you received medical help, which symptoms were mentioned at the time and how they developed. Also think of attempts to return to work or resume your studies, and of referrals. A timeline helps when information is spread across your GP, the hospital and other treating practitioners.
If you initially reported little, explain factually why, as far as you know the reason. Perhaps other injuries took priority, or you only noticed problems when you resumed activities. A limitation discovered later is not automatically implausible, but the passage of time may raise questions that need to be answered.
Have inaccuracies in reports raised through the proper channels. Do not rewrite old medical records yourself. An additional explanation can sometimes help, but it must remain recognisable as information added later. A verifiable file is more important than a story that looks perfect with hindsight.
Making concentration problems and sensory overload concrete
A term such as sensory overload is not self-explanatory to a claims handler. Describe which situations are difficult: a busy office, several conversations at once, screen work or travelling at rush hour. Note how long you can keep up an activity, what happens afterwards and which adjustment helps.
Do the same for concentration. Which tasks take more time? Are you making mistakes you did not make before? Do you need to take breaks? Factual examples support the assessment without you having to draw a medical conclusion yourself. A diary does not need to be extensive to contain useful information.
The relationship between activities is also relevant. A short walk and a working day with complex tasks make different demands. The fact that you can carry out one activity does not automatically prove that the other is also feasible. At the same time, inconsistencies in your functioning should be investigated seriously rather than ignored.
Returning to work and loss of earning capacity
With persistent symptoms, adapted work may be necessary, for example fewer hours, fewer stimuli or a different division of tasks. The company doctor and the employer each have their own role in this. For the personal injury claim, it must be investigated which limitations exist as a result of the accident and what they mean for your income.
Keep reintegration agreements and evaluations. A failed attempt to build up your hours can provide important information, provided it is clear what was tried and why it did not work. An initial partial return to work does not automatically mean a lasting recovery. Conversely, long-term total incapacity for work must not be assumed without substantiation.
For the calculation, the income actually received is compared with a plausible situation without the accident. Salary, allowances and career expectations must be substantiated. For self-employed people, assignments, costs and business results are also relevant. A general description of symptoms is no substitute for that financial comparison.
Studies and delayed education
A student may have difficulty reading, attending lectures or sitting exams. Ask the educational institution for concrete arrangements on adjustments and record which components are postponed. A study adviser can provide information on the normal study path and the actual delay.
A delay in your studies is not the same as every missed class. For a claim, it must become clear which additional year of study or which costs arise from the accident and which consequences are sufficiently plausible. Guidelines may offer a tool in certain situations, but whether they apply must be checked.
Keep enrolments, results, timetable changes and correspondence about adapted exams. Your previous academic progress is also relevant for the comparison. This helps prevent a delay from being attributed too generously or, on the contrary, underestimated because only the credits obtained are considered.
Help with household tasks and organising everyday matters
Persistent symptoms can also affect daily tasks. Perhaps you can still manage the cleaning, but not on top of work and treatment, or you need help planning appointments. Describe what has changed as a result of the accident and what support is actually provided.
Distinguish between household help, support and guidance, and the normal support within a family. Not every form of helping out counts as separately compensable care. Where there is a concrete additional need for help, its necessity, extent and an appropriate estimate must be examined. An expert can assist if this is complicated.
Record tasks and periods. Also note when you are able to do something yourself again. An up-to-date overview carries more weight than a single overall number of hours per week given after the event. It prevents improvements, or indeed setbacks, from being left out of the damage calculation.
Treatment costs and compensation for support
Necessary and reasonable costs arising from the accident may form part of the claim. Check what your health insurance covers and what personal contribution remains. Keep invoices, referrals and statements. The connection between the treatment and the consequences of the accident must be explained.
Non-standard or expensive treatment programmes require extra attention to substantiation and reasonableness. The fact that a provider promises improvement does not automatically mean the costs are recoverable. Discuss your choices with your healthcare provider and your legal representative and, where possible, seek clarity in advance.
Travel expenses and other necessary expenditure may also be relevant. Keep an overview of visits and payments. An insurance policy that does not cover a treatment does not thereby automatically decide the civil claim; both assessments have their own starting points.
Medical adviser and independent expert
A medical adviser can collect and assess relevant information for the settlement of the claim. That is a different role from that of your treating practitioner. The treating practitioner focuses on care; an adviser or expert can assess questions about limitations, prognosis and the link with the accident.
If the parties disagree, an independent expert examination may be appropriate. The choice of expertise must match the question. Not every file calls for the same examination, and a test result must be interpreted in the right context. The expert examination does not guarantee a desired legal outcome.
Discuss in advance which information is needed and which questions will be asked. Carefully worded questions also explore alternative explanations and uncertainties. That makes the report more useful than an instruction that only seeks confirmation of one position.
Previous symptoms and other possible causes
If you already had headaches, fatigue or concentration problems before the accident, that is relevant. It does not automatically rule out a claim. It must be investigated what already existed, what changed after the accident and how the situation would probably have developed without the accident.
Provide your relevant medical history in full. How you functioned before the incident is often important: did you work without limitations, were you following a course of study, and were you receiving treatment? The existence of an old diagnosis does not in itself say what your daily capabilities were at the time.
New events after the accident may also play a role. A second incident or another medical development must be dealt with carefully. This prevents an incorrect all-or-nothing approach and helps to assess the relevant consequences period by period.
Compensation for pain and suffering with invisible limitations
Compensation for pain and suffering (smartengeld) is not limited to injuries that are visible from the outside. Pain, limitations and loss of enjoyment of life can be relevant. The legal basis and the amount must, however, be substantiated with reference to your medical and personal situation.
Describe which activities have changed and what that means for you. A busy family, social life or demanding profession can reveal consequences other than those shown by a general questionnaire. It is not about the number of words used to describe symptoms, but about a credible picture of the impact.
There is no fixed amount of compensation for post-concussion symptoms. Recovery time, severity, treatments and permanent consequences can differ. Case law can provide guidance, but only when the relevant facts are compared. Compensation for pain and suffering stands alongside financial heads of damage such as income and help.
Fictitious example of a return to the office
After a collision, an employee continues to suffer from headaches and difficulty concentrating. The scan shows no abnormality. When the employee returns to work in a busy open-plan office, the symptoms increase. This example is fictitious and is not a medical diagnosis or a client’s story.
The employee discusses the course of the symptoms with healthcare providers and the company doctor. A concrete plan for building up work is drawn up and a record is kept of which tasks can be managed. For the claim, the initial medical records, evaluations and the financial effect are gathered. The normal scan is not used as the only decisive factor.
If the employee’s capacity remains uncertain over time, it is assessed which additional information is needed. A final settlement is tested against the actual development and prognosis. This prevents a brief attempt at work from wrongly being treated as full recovery, or permanent incapacity from being assumed without investigation.
Example of a capacity diary
A diary only works if it is short. Four lines a day, for one week, is enough to reveal a pattern. Preferably fill it in at the end of the day, not while you are experiencing symptoms.
| Day | Activity | How long | What happened afterwards | Recovery time |
|---|---|---|---|---|
| Mon | Two hours of screen work | 2 hours | Headache, difficulty finding words | Lay down for the rest of the afternoon |
| Tue | Shopping at the supermarket | 25 min | Dizzy at the checkout, had to go outside | 1.5 hours |
| Wed | Quiet day, no appointments | – | Reasonable day, mild headache in the evening | – |
| Thu | Birthday party, six people | 1 hour | Overstimulated, could not follow the conversation | Still tired the next morning |
| Fri | Took child to school and cooked | 2 × 30 min | Went well, but went to bed early | – |
A capacity diary without overexertion
A diary can help make the pattern of your symptoms visible, but it does not need to become an intensive daily task. Choose a simple format that suits your capacity. For example, note the main activity, how long it lasted, the problems you experienced and the rest you needed. If necessary, ask someone to help with the practical side, without them filling in your experiences for you.
The aim is not to measure every feeling. What matters more is whether there is a recognisable connection between activities and limitations. A busy meeting may turn out differently from reading quietly at home. Describe the circumstances so that differences between days become understandable. Also note what goes well and which adjustments work.
Use the overview in discussions with your treating practitioner, company doctor or legal representative. Your own records are not independent medical proof of the cause, but they can help focus the questions and clarify the day-to-day consequences. They are no substitute for a professional assessment.
Also discuss how information will be shared. A fully personal diary may contain more than is needed for the claim. A focused summary of relevant activities and limitations can sometimes be more appropriate. Your medical adviser can help define which information is required.
If keeping records becomes too demanding in itself, adjust your approach. A periodic overview or short notes around important changes can be useful. The file should support your situation and must not become an additional recovery task. Above all, keep information about building up work, setbacks, study adjustments and your need for help in a way that you can realistically keep up.
How the law deals with symptoms without a visible abnormality
With these symptoms in particular, the legal question is not a medical-technical one but a question of attribution and proof:
- Article 6:98 of the Dutch Civil Code (BW): the core provision. Compensation is awarded for the loss that can be attributed to the accident as its consequence. The courts accept that symptoms which by their nature are difficult to establish objectively can nonetheless be attributed. The leading judgment is Supreme Court (Hoge Raad) 8 June 2001, ECLI:NL:HR:2001:AB2054 (NJ 2001/433). In that case, the Supreme Court upheld the finding that, in the case of a syndrome which is generally known to be difficult, or only to a limited extent possible, to trace back to concretely observable medical disorders, the requirements for proof of the causal link must not be set too high. The absence of a specific, medically demonstrable explanation for the symptoms is at the risk of the person who caused the damage, in the sense that it does not prevent a finding that the causal link has been proven. What does matter: it must be possible to establish objectively that the symptoms are present, real, not imagined, not feigned and not exaggerated.
- Article 6:97 of the Dutch Civil Code: the court may estimate the damage where an exact calculation is not possible; this is often the case where capacity fluctuates.
- Article 6:162 of the Dutch Civil Code or Article 185 of the Road Traffic Act (WVW): the basis for liability, depending on how the accident happened.
- Article 6:96 of the Dutch Civil Code: compensation for treatment costs, for help with organising and planning, and for the reasonable costs of medical advice.
- Article 6:106 of the Dutch Civil Code: compensation for pain and suffering. Invisible limitations can be far-reaching; the compensation follows the consequences for your life, not the visibility of the injury.
- Article 202 of the Dutch Code of Civil Procedure (Rv): if the disagreement persists, a request can be made for a provisional expert report; see medical expert examination in personal injury cases.
The articles have been checked on wetten.overheid.nl. A normal scan does not refute your symptoms, but it is not a free pass either. Consistency in the file carries a lot of weight, but it is not the only factor: how the accident happened, the course of treatment, statements from treating practitioners, observations at work and the question of whether another cause could explain the symptoms all count in the assessment.
Frequently asked questions about concussion and personal injury
Can I receive compensation without an abnormality on a scan?
Yes, that is possible. A normal scan does not automatically rule out all relevant symptoms. How the accident happened, the medical information, the course of the symptoms and the limitations are assessed together. The link with the accident must, however, be carefully substantiated.
How long can symptoms last after a concussion?
There is no personal recovery period that can be derived from a legal article. Discuss persistent or changing symptoms with your treating practitioner. For the claim, what matters is the medically substantiated development of your own situation.
Is sensory overload sufficient proof of incapacity for work?
Not on its own. Describe which work you cannot do because of it and have the limitations assessed. Medical information, observations at work and reintegration records may together be relevant. The financial loss also requires a separate calculation.
Can I claim for a delay in my studies?
Yes, if the delay and its consequences can be sufficiently attributed to the accident. Gather information from the educational institution and about your previous progress. Not every missed class or exam attempt automatically leads to compensation for a full year.
Do I have to undergo an independent examination?
That depends on the questions in your file and the need for evidence. Discuss the expertise, the questions to be put and your rights and obligations. An examination must be relevant and proportionate and is no substitute for treatment.
What if the insurer does not accept my symptoms?
Ask which elements are disputed and on what information that is based. Additional medical records, a better timeline or an independent expert examination can sometimes help. The right next step depends on the specific dispute.
Can I already receive an advance payment?
That is possible if liability and certain heads of damage are sufficiently established. A substantiated request setting out costs and payments received makes clear what is needed. An advance payment does not have to mean that the entire case is closed.
The insurer says my symptoms cannot be objectified. What now?
Ask which medical information supports that position. The legal criterion is not whether symptoms are visible on a scan, but whether they are real and plausibly connected to the accident. A consistent picture in the GP’s records, referrals, treatment reports and absence file carries a lot of weight in this respect.
How do I record sensory overload and fatigue without overexerting myself?
Keep it short and factual: two or three lines a day on what you did, for how long, and what the result was. For example: ‘an hour and a half at the screen, then had to lie down for two hours’. Do this for a defined period, for example six weeks. The diary does not replace medical information, but it makes the consequences between appointments easier to discuss.
What if I suffer a setback months into returning to work?
A setback is not proof that you are unwilling. Report it to the company doctor and your treating practitioner and have it included in the reintegration file. For the damage calculation, what counts is your lasting capacity, not a brief trial. Build up with concrete hours and tasks, and record what did and did not prove sustainable.
A careful picture of your symptoms and losses
Arslan Advocaten can work with you to establish which information is needed to substantiate persistent symptoms and their financial consequences. Bring your medical correspondence, information about your work or studies and letters from the insurer. We will discuss a suitable approach and clear agreements on costs.
Read more about personal injury or contact us about your situation.
Related articles
- Two accidents with the same symptoms
- Provisional expert report in personal injury cases
- Acquired brain injury (NAH) and personal injury
- Compensation for delayed studies
- Medical expert examination in personal injury cases
- What does a medical adviser do
- Loss of income and loss of earning capacity
Sources and further information
- Thuisarts on long-term symptoms after a head injury
- Dutch Brain Foundation on concussion and brain contusion
- The Dutch judiciary (Rechtspraak) on personal injury
- The Dutch Personal Injury Council (De Letselschade Raad) on guidelines
