Types of injuries

Which injuries are most common?

Personal injury takes many forms. Sometimes the damage is immediately visible, such as a broken leg or a deep wound. But very often, it involves injuries that are not visible from the outside: a whiplash after a rear-end collision, a concussion that simply won't heal, permanent brain damage, or the psychological consequences of a shocking event. It is precisely with this invisible injury that most disputes arise with insurers, even though the impact on your life can be enormous.

Important to know: whether you are entitled to compensation depends not only on the type of injury, but primarily on the cause. Liability is determined by what happened. If someone hit you, liability lies with the person who caused the traffic accident. If it happened at work, your employer is usually liable. Different rules apply in the case of an animal bite or violence. The type of injury primarily determines the amount and nature of your compensation, while the cause determines who has to pay.

Below, we discuss the injuries we see most frequently, with an emphasis on the invisible consequences. For each injury, we explain what it entails, why insurers sometimes object, and how you can still stand strong.

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Whiplash: invisible but real

A whiplash is caused by a sudden, forceful movement of your head and neck, usually during a rear-end collision. Your neck makes a whip-like movement in a fraction of a second, causing muscles, ligaments, and nerves to become overstretched. Symptoms often do not begin until hours or even days later: neck pain, headache, dizziness, fatigue, concentration and memory problems, and sometimes tingling in the arms or hands.

The frustrating thing about whiplash is that usually nothing is visible on an X-ray, CT scan, or MRI. This is because whiplash is not a fracture or visible damage, but rather a pattern of symptoms. Medically, this is called Whiplash Associated Disorder (WAD). The Quebec Task Force classifies whiplash into grades:

• WAD grade 0: no complaints and no physical symptoms.
• WAD grade 1: only complaints of neck pain, stiffness, or tenderness, without physical abnormalities.
• WAD grade 2: neck complaints in combination with limited range of motion or tenderness of the muscles.
• WAD grade 3: neck complaints with neurological deficits, such as reduced reflexes or loss of strength.
• WAD grade 4: neck complaints with a fracture or dislocation of the vertebrae.

Most whiplash cases fall under grade 1 or 2, precisely the cases where scans show nothing. That does not make these symptoms any less real. For many people, the symptoms resolve within a few weeks to months, but for some, they persist for a long time and lead to permanent limitations in work and private life.

Proof of causal link in whiplash

Because whiplash is rarely objectively visible on a scan, discussions with the insurer almost always revolve around the causal link: is there a causal connection between the accident and your symptoms? Insurers frequently attempt to cast doubt on this connection by arguing that there is no medically verifiable injury. However, case law in the Netherlands is clear on this point and favorable to victims.

No medically verifiable basis is required to establish a causal link in whiplash . Therefore, nothing needs to be visible on a scan. The legal test is different. The link between the accident and the symptoms is assumed if the following conditions are met:

• The complaints are real: they are not feigned or exaggerated.
• The complaints are consistent: over time, they are interconnected and fit together.
• The complaints are plausible: they are medically quite conceivable given the nature of the accident.
• The accident can explain: these complaints were not present before the accident, and the nature of the collision is consistent with how they occurred.
• The symptoms lead to functional limitations: due to the symptoms, you can no longer do certain things, or can do them less well.

How do you build this evidence? You do this primarily through your medical records and consistent documentation of your complaints. Always consult your GP regarding complaints so that everything is recorded. Keep a complaint diary if necessary. Collections of treatments by a physiotherapist, neurologist, or rehabilitation physician reinforce the picture of consistent complaints. In many cases, an independent medical expert is later called in to assess whether the complaints are real, consistent, and plausible, and what limitations result from them. An experienced advocate ensures that this is done carefully and in your favor.

Acquired brain injury (ABI)

Acquired brain injury, abbreviated as ABI, is any brain damage that occurs during the course of life and is therefore not present from birth. In cases of personal injury, it usually involves traumatic brain injury: damage to the brain caused by a blow or impact, for example in a traffic accident, a fall from a height, or a workplace accident. The consequences can be profound and permanent.

Acquired brain injury is called the 'invisible injury' for good reason. A person may appear largely physically recovered, while their functioning has changed drastically. Common consequences include:

• Memory and concentration problems.
• Rapid and extreme fatigue (neurofatigue).
• Hypersensitivity to stimuli such as light, sound, and crowds.
• Changes in behavior and character, such as irritability or impulsivity.
• Reduced insight into the illness: the victim sometimes does not notice themselves how much it has changed.

It is precisely these behavioral and personality changes that make acquired brain injury so difficult, also for partners, children, and colleagues. The injury affects not only you, but your entire environment. In cases of severe brain injury, the damage is often substantial: loss of earning capacity, costs for care and assistance at home, home modifications, and permanent dependence on others. A careful calculation of personal injury damages is essential in this regard, as many of these costs only become apparent over the course of years.

Concussion and post-concussion syndrome

A concussion is a mild form of traumatic brain injury caused by a blow or hard movement of the head. In medical terms, this is called a minor traumatic brain injury. You often lose consciousness briefly or experience short-lived confusion, followed by a headache, nausea, dizziness, and sensitivity to light. For most people, these symptoms disappear completely within a few days to weeks.

However, in some victims, the symptoms persist for much longer. If the symptoms persist for weeks to months, it is referred to as post-concussion syndrome (PCS). The symptoms resemble those of whiplash and acquired brain injury: persistent headaches, fatigue, concentration and memory problems, irritability, sleep problems, and hypersensitivity to light and sound. As with whiplash, these symptoms are usually not visible on a scan, which allows the insurer to dispute the causal link.

Here too, the absence of visible injury does not mean you are not entitled to compensation. The legal assessment is the same as for whiplash. Ensure that your symptoms are well documented with your general practitioner and treating physicians, so that the progression is demonstrably consistent. In the case of long-term symptoms, a neurologist or neuropsychologist can assess the limitations.

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Neck and back injuries

Neck and back injuries occur in many forms. Sometimes they involve bruises and strains of muscles and ligaments, which heal with rest and physiotherapy. In more serious cases, damage occurs to the spine itself: a herniated disc, a vertebral fracture, or damage to the spinal cord. This latter category can lead to permanent disability, loss of strength, sensory disturbances, or, in the worst case, paraplegia.

Back problems have a major impact on daily life. Bending, lifting, sitting, or standing for long periods can suddenly become impossible. For people with physically demanding jobs, this often means they can no longer practice their profession. Here, too, the discussion regarding causality plays a role, particularly for people who already experienced occasional back problems before the accident. The question then is what proportion of the complaints is caused by the accident. A good advocate ensures that this demarcation is conducted fairly and that a pre-existing vulnerability is not used as an excuse to limit your compensation. After all, in law, you must take the victim as they are, even if they already had a weak spot.

Psychological injury and PTSD

Not all injury is physical. An accident, a robbery, violence, or the loss of a loved one can leave deep psychological scars. Common symptoms include anxiety, panic attacks, depression, sleep problems, flashbacks, and avoidance of situations that remind one of the event. When these symptoms are severe and long-lasting, it may indicate post-traumatic stress disorder (PTSD).

PTSD is a recognized psychiatric condition, included in the official classification systems for mental disorders. A diagnosis by a psychiatrist or psychologist is of great importance in this regard. However, there is a legal threshold for compensation for psychological injury : there must be a recognized psychiatric condition that has affected your personal integrity. Ordinary grief, shock, or disappointment is not sufficient; it must involve an established disorder such as PTSD, a depressive disorder, or an anxiety disorder resulting from the event.

If that threshold is met, you are entitled to reimbursement for your treatment costs, loss of income, and pain and suffering. Moreover, psychological injury often goes hand in hand with physical injury: someone with a severe whiplash or acquired brain injury not infrequently develops depressive or anxiety symptoms as well. It is important that all these consequences are included in your file.

What damages can you claim?

For each of these injuries, you are entitled to compensation for all damage you suffer as a result of the accident. We divide this damage into two main groups. Material damage consists of all concrete costs and losses, such as:

• Loss of income, now and in the future, if you are (partially) no longer able to work.
• Medical costs, deductible, physiotherapy and rehabilitation.
• Travel expenses to doctors and practitioners.
• Costs for domestic help and informal care.
• Modifications to your home or car.
• Study delay or missing out on a degree.

In addition, there is non-material damage, better known as pain and suffering. This is compensation for suffering, pain, loss of enjoyment of life, and the impact on your well-being. It is not a reimbursement of costs, but an acknowledgment of the impact the injury has had on you. A full calculation of your personal injury damages brings all these items together so that you do not miss out on anything.

Good to know: the costs of legal assistance are also included in the damages. Pursuant to Article 6:96 of the Dutch Civil Code (reasonable costs for establishing damage and liability), the liable insurer must reimburse the costs of your legal representative. As a result, our assistance is free of charge once liability has been established.

How much compensation for pain and suffering per injury?

In the Netherlands, the amount of compensation for pain and suffering is determined based on previous rulings compiled in the ANWB Pain and Suffering Guide. Judges and legal representatives consult this guide to determine an appropriate amount. Therefore, there is no fixed table; each case is assessed individually based on the severity of the injury, the duration of the symptoms, the treatments received, and the impact on your life.

To give you an idea, however, below are some indicative ranges. Please keep in mind that this is only a rough indication and that every case is unique:

• Mild whiplash with recovery within a year: indicative, a few hundred to approximately 2,500 euros.
• Whiplash with long-term or permanent symptoms and limitations: indicative roughly 5,000 to 20,000 euros, depending on the severity.
• Concussion with post-concussion syndrome: indicative 2,500 to 15,000 euros, depending on duration and limitations.
• Neck and back injuries with permanent disabilities: indicative, several thousand to tens of thousands of euros.
• Acquired brain injury: varies widely, from a few thousand euros for minor injury to well over 100,000 euros for very severe permanent injury.
• PTSD and other recognized psychological injury: indicative 1,500 to 25,000 euros or more, depending on severity and recovery.

Once again: these amounts are indicative and serve only as a guideline. The actual compensation for pain and suffering in your case may turn out higher or lower. Read more about how this is determined on our page about compensation for pain and suffering.

Do I need a personal injury expert?

You are not obliged to seek assistance, but it is advisable. The opposing party's insurer has years of experience with personal injury claims and primarily looks after its own financial interests. An initial offer is often much lower than what you are actually entitled to, and particularly in cases of invisible injury, the causal link is systematically called into question. With expert assistance on your side, the balance is more even.

An experienced legal representative ensures that your medical records are in order, calculates your full damages, conducts negotiations, and monitors legal deadlines. The latter is important: a claim for compensation generally lapses after five years, calculated from the moment you become aware of the damage and the liable party. Therefore, do not wait too long to report your case.

The best part is that good help doesn't have to cost you anything. Because the liable insurer reimburses the reasonable costs of legal assistance pursuant to Article 6:96 of the Dutch Civil Code, our guidance is free of charge as soon as liability has been established. You therefore do not have to choose between your recovery and your rights. Do you want to know where you stand? Feel free to contact us without obligation, and we will look at your situation together.