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Reliving the Nightmare: Post-Accident PTSD


Personal injuries are not always physical ones. For many victims of motor vehicle accidents, after a car wreck, the emotional impact can be just as bad, or even worse, than the physical injuries. Unfortunately, many car accident victims struggle with undiagnosed and untreated anxiety or post-traumatic stress disorder (PTSD). In fact, research shows that if you've been involved in a motor vehicle accident, you're at risk for developing post-traumatic stress disorder (PTSD). Research shows that about 9 percent of the general population who are in car accidents develop PTSD. Reported rates of MVA-related PTSD have varied across studies depending on the methodologies employed to quantify these rates; however, from the approximately two dozen studies assessing samples consisting largely of MVA survivors (often recruited from emergency room admissions or hospital wards) and using well-validated, structured interviews, the presence of PTSD at least 30 days post-MVA is approximately 25-33% (e.g., Bryant, Harvey, Guthrie, & Moulds, 2000; Harvey & Bryant, 1998; Ursano et al., 1999).That number is significantly higher for people who have been in a car accident and seek mental health treatment, with an average of 60 percent diagnosed with PTSD. Below, we explain how to identify PTSD, its impact on your legal claim, and finally, how Drinkwater & Goldstein, LLP has helped PTSD victims recover from a car or truck crash.


After a serious car crash, it is common to feel overwhelmed by emotion. In 2016, for example, the National Highway Traffic Safety Administration (NHTSA) concluded that the number of fatal car accidents that year had increased by 2.2 percent from the previous year, resulting in a total of 0.7% of all crashes being fatal. While this may seem like a small percentage, given the huge number of accidents each year, this works out to approximately 1.3 million MVA-related fatalities each year. It’s no surprise then that survivors of a crash could feel emotional – a close brush with death can certainly have that effect. For many people though, these symptoms fade over time; however, if you’re still dealing with nightmares, intrusive thoughts, edginess, and trauma-related triggers after a month, you may be experiencing PTSD.

Post-traumatic stress disorder is more than being afraid of driving or having an occasional nightmare. The American Psychiatric Association (APA) defines PTSD as, “a psychiatric disorder that can occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, rape, or other violent personal assault.” In 2013, the APA revised the diagnostic criteria for PTSD in the 5th edition of the Diagnostic & Statistical Manual of Mental Disorders (DSM-V). All of the following criteria are now required for a diagnosis of PTSD:

Criterion A: stressor (one required)

The person was exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, in the following way(s):

  • Direct exposure

  • Witnessing the trauma

  • Learning that a relative or close friend was exposed to a trauma

  • Indirect exposure to aversive details of the trauma, usually in the course of professional duties (e.g., first responders, medics)

Criterion B: intrusion symptoms (one required)

The traumatic event is persistently re-experienced in the following way(s):

  • Unwanted upsetting memories

  • Nightmares

  • Flashbacks

  • Emotional distress after exposure to traumatic reminders

  • Physical reactivity after exposure to traumatic reminders

Criterion C: avoidance (one required)

Avoidance of trauma-related stimuli after the trauma, in the following way(s):

  • Trauma-related thoughts or feelings

  • Trauma-related external reminders

Criterion D: negative alterations in cognition and mood (two required)

Negative thoughts or feelings that began or worsened after the trauma, in the following way(s):

  • Inability to recall key features of the trauma

  • Overly negative thoughts and assumptions about oneself or the world

  • Exaggerated blame of self or others for causing the trauma

  • Negative affect

  • Decreased interest in activities

  • Feeling isolated

  • Difficulty experiencing positive affect

Criterion E: alterations in arousal and reactivity

Trauma-related arousal and reactivity that began or worsened after the trauma, in the following way(s):

  • Irritability or aggression

  • Risky or destructive behavior

  • Hypervigilance

  • Heightened startle reaction

  • Difficulty concentrating

  • Difficulty sleeping

Criterion F: duration (required)

Symptoms last for more than 1 month

Criterion G: functional significance (required)

Symptoms create distress or functional impairment (e.g., social, occupational)

Criterion H: exclusions (required)

Symptoms are not due to medication, substance use, or other illness


Unfortunately, PTSD and chronic pain go hand-in-hand. Another study from the NHTSA reports that 50% of car crash victims with chronic pain also have PTSD. Many do not realize that chronic pain damages your mental health. The strain of daily, severe pain, your inability to work and do things you love, and the frustration of ineffective pain treatment can cause mental health symptoms. Examples include:

  • Depression

  • Thoughts of suicide

  • Decreased feelings of self-worth

  • Struggling with identity

  • Questioning your values

Additionally, the pain, disability, and changed circumstances may serve as a daily reminder of your crash. For some car crash victims, a pain flare or disability can be a constant reminder of their trauma and trigger PTSD symptoms.


Insurance adjusters are very often skeptical of PTSD injury claims. They unfairly argue that PTSD is always exaggerated to maximize a personal injury claim – and victims will miraculously improve after a settlement. This argument is unfounded and contrary to clinical studies on PTSD and car accidents.

Perhaps as a side-effect of the grief and aggravation caused by insurance companies’ continued skepticism over post-MVA PTSD claims, data from a recent multi-year study which followed a group of 171 motor vehicle accident survivors revealed that just over half of the victims filed a lawsuit. In direct refutation of insurance companies’ allegations that complaints of PTSD are exaggerated to maximize financial recovery and that plaintiffs’ complaints cease after settlement, the study found that three years after their car crashes, there was almost no difference in the frequency of PTSD and psychological injuries in the group of accident survivors, and further, that after six years, approximately 85% of the victims who had settled their lawsuits, still did not show any dramatic improvement in their PTSD, chronic pain, or other symptoms.

Based on this study and others, psychiatrists, clinicians, and legal professionals have further evidence that – despite the assertions of insurance adjusters (who motto is, “delay, deny, defend…”) – there isn’t evidence of widespread fraud in post-MVA PTSD claims.

However, insurance companies, even despite the facts, may still be unsympathetic to your claim of psychological harm. If an adjuster can find inconsistencies in your psychiatric records or what they view as problems with respect to your psychiatric treatment, or if you have a preexisting mental health issue, the adjuster may very well deny your claim.


As this article has made clear, PTSD is not an easy diagnosis for anyone – not for the victim who has to experience the physically, mentally, and emotionally draining symptoms; not for the insurance companies who are hasty to challenge the veracity of such claims; and not for the personal injury attorney whose job it is to ensure that the client suffering from PTSD as a result of an accident gets the financial recovery they deserve.

It is paramount, therefore, that if you or a loved one are struggling with PTSD or other injuries after a serious car or truck accident, that you contact an experienced, compassionate, and knowledgeable personal injury attorney. Drinkwater & Goldstein, LLP can help guide you, not only through your legal claim, but through your medical treatment as well, having helped countless other clients along the rigorous road of post-accident PTSD and anxiety. Contact us today so that our compassionate and judgement-free staff can walk you through a free, no-risk consultation. For decades, the experienced personal injury attorneys at Drinkwater & Goldstein, LLP have been helping accident victims pick up the pieces after a traumatic accident, helping them rebuild their lives and journey towards recovery. Call Drinkwater & Goldstein, LLP today at (856) 753-5131, find us online at, or visit our YouTube Channel by searching “Drinkwater & Goldstein” on YouTube.

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