When the Tests Say "Normal," But the Injured Worker Doesn’t Feel Normal

Managing Persistent Head Injury Symptoms in Autistic Adults

One of the most challenging scenarios in workers’ compensation brain injury claims occurs when the diagnostic workup looks reassuring, but the injured worker continues to report significant symptoms.

Now add another layer: the injured worker is an autistic adult.

A question submitted by an attendee at MTI America’s recent Brain & Spine CEU captured the challenge well:

“I had a closed head injury claim involving an autistic adult. It becomes very difficult to manage when the diagnostics show everything is good, but the injured worker remains symptomatic. Where do you go from there?”

It’s an important question because a “normal” test result does not necessarily mean the injured worker has returned to their pre-injury level of function.

Normal Imaging Is Not the Same as No Symptoms

CT scans and MRIs are essential tools for identifying structural abnormalities such as bleeding, fractures, swelling, or other significant pathology. But persistent symptoms following a concussion or mild traumatic brain injury may occur even when conventional imaging does not reveal an obvious structural explanation.

The injured worker may continue to experience:

• Headaches or dizziness
• Sensitivity to light or sound
• Fatigue
• Sleep disturbances
• Problems with concentration or memory
• Balance or vestibular issues
• Changes in mood or behavior
• Difficulty tolerating environments or activities that were manageable before the injury

For the claims professional, this creates a difficult situation: How do you move a claim forward when the objective testing and the injured worker’s reported experience do not seem to match?

The answer may be to shift the question from “What does the scan show?” to “What has changed functionally?”

Autism Adds Another Layer to the Clinical Picture

Every autistic adult is different. However, autism can affect communication, sensory processing, routines, emotional regulation, and how discomfort or changes in function are expressed.

That makes establishing the injured worker’s pre-injury baseline particularly important.

Thank You for Joining Us on the Red Carpet at WCI!

We loved connecting with so many familiar faces and new friends at WCI 2026! Thank you to everyone who stopped by the MTI America booth, said hello, snapped a photo, and spent time with our team.

It’s the relationships we build across the workers’ compensation community that make events like WCI so valuable. Thank you for making WCI 2026 one to remember. We look forward to seeing you again next year!

More Than a Ride: Transportation’s Role in Brain & Spine Injury Recovery

Getting to care safely can be just as important as the care itself.

When managing a complex brain or spine injury claim, attention naturally focuses on the big clinical decisions: specialists, surgery, rehabilitation, therapy, medications, and return-to-work planning.

Read More >>

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