PTSD after a car accident: emotional distress and your claim

Emotional reactions after a crash#

The National Institute of Mental Health (NIMH) says people can have a range of reactions after living through or witnessing a traumatic event, such as a serious accident: feeling anxious, sad or angry, having trouble concentrating and sleeping, and thinking about what happened. It estimates that about half of US adults will experience at least one traumatic event, and that most do not develop PTSD.

The VA's National Center for PTSD describes PTSD as a mental health problem that can only develop after going through or seeing a life-threatening event. It says stress reactions are normal, and that if symptoms last longer than a month and are causing problems in your life, it could be PTSD. The VA describes four types of symptoms:

• Reliving the event, such as nightmares, flashbacks or reactions to reminders.
• Avoiding reminders. The VA's own example is avoiding driving after a car accident.
• More negative thoughts and feelings, such as numbness, guilt or losing interest in things.
• Feeling on edge, such as trouble sleeping or concentrating, or being easily startled.

These descriptions help explain what a claim is about. They are not a checklist for diagnosing yourself or anyone else: a qualified professional makes that call. Head injuries can cause overlapping symptoms, which our traumatic brain injury guide covers.

Emotional distress as part of a claim#

Emotional harm is usually claimed as part of non-economic damagesNon-economic damages. Losses without a price tag, such as pain, suffering, emotional distress and loss of enjoyment of life. Glossary, alongside physical pain. State laws use different words for it:

The costs of care are economic damagesEconomic damages. Losses with a receipt or a paycheck behind them: medical bills, lost wages, repairs and other out-of-pocket costs. Glossary: visits to a psychologist, psychiatrist or counselor, prescriptions and travel to appointments. So is pay lost to missed work. Our guide to pain and suffering explains how the non-economic side is valued.

Most emotional-distress claims after a crash come with a physical injury. The rules for people who were frightened or witnessed a crash but were not physically hurt vary a great deal from state to state, so that situation is worth raising with a licensed attorney.

Documenting emotional harm#

Insurers tend to question injuries they cannot see. The strongest evidence of emotional harm is the same kind of evidence used for a broken arm: dated records from health professionals. Many people first mention symptoms to their family doctor or at a follow-up visit, and those notes become part of the record.

Records that often matter:

• notes from the doctors, psychologists, psychiatrists or counselors who saw you, with dates;
• any diagnosis a qualified professional made, and when;
• bills, receipts and pharmacy records;
• work records that show missed shifts, reduced hours or changed duties;
• a short journal of sleep, fears, driving and activities you stopped doing;
• statements from family or coworkers who noticed changes.

Under HIPAA, a provider must act on your written request for your own records within 30 days. Our guide to medical records explains how to request them.

Privacy: when mental health is at issue#

What you tell a therapist is normally private. Evidence rules protect it in court through a psychotherapist-patient privilegePsychotherapist-patient privilege. A rule that keeps what a patient tells a mental-health professional out of court, with exceptions, such as when the patient makes their own mental condition an issue in a lawsuit. Glossary, as in California, and federal privacy law adds rules for psychotherapy notes: under HIPAA, a provider needs the patient's authorization before disclosing psychotherapy notes, with few exceptions.

Claiming emotional distress changes the picture. When you ask for money for harm to your mental health, you put that condition "at issue", and the other side can ask for records that bear on it. California's evidence code is a clear example: there is no privilege for communications relevant to the patient's mental or emotional condition once the patient puts that condition at issue.

In a lawsuit, the defense can also ask for an exam. In federal court, for example, a court may order a party whose mental or physical condition is in controversy to be examined, on motion for good cause. The same federal rules also say a court may, for good cause, limit or forbid discovery to protect a party from annoyance, embarrassment, oppression, or undue burden or expense. State courts follow their own rules.

No-fault states and emotional harm#

In no-fault states, your own personal injury protection pays some costs first, whoever caused the crash. In New York, the basic no-fault benefit covers necessary expenses that include psychiatric services, within its limits. Other states' PIP coverage differs.

Suing the other driver for pain, suffering or mental anguish in a no-fault state usually means meeting a serious injury thresholdSerious injury threshold. A rule in some no-fault states that lets you sue the at-fault driver for pain and suffering only if your injury meets a legal definition of serious, or a dollar level of medical bills. Glossary:

Whether a mental-health condition can meet these tests depends on the facts and on how courts in that state read the law. A licensed attorney in your state can explain how the threshold applies.

Deadlines for emotional distress claims#

An emotional distress claim follows the same filing deadline as the rest of the injury claim. The clock usually starts on the day of the crash, not on the day a diagnosis is made. The deadline is 2 years in Texas, 2 years in California and 3 years in New York. Check your state on the state deadlines page, and see the claim process guide for the steps of a claim.

Getting support#

If you are in crisis or thinking about suicide, the 988 Suicide & Crisis Lifeline is free and confidential, around the clock: call or text 988, or chat online. The VA's National Center for PTSD and NIMH also publish plain-language information about trauma and PTSD, listed in the sources below.