Vestibular injury BPPV accident attorney

Dizziness after a head injury is frequently dismissed as vague, and it is one of the few post-traumatic symptoms that can be measured objectively. Benign paroxysmal positional vertigo, in which displaced particles in the inner ear produce brief violent vertigo on certain head movements, has a diagnostic examination with a visible physical sign. That makes it valuable evidence in a category of injury where objective findings are otherwise scarce. Law Offices Of SRIS, P.C. handles head injury claims in Virginia, Maryland, the District of Columbia, New Jersey and New York.

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What the examination shows

Diagnosis is clinical rather than radiological. Positional testing provokes the vertigo and produces a characteriztic involuntary eye movement, which an examiner can observe directly and which can be recorded with video goggles. That recording is objective evidence in the plainest sense. Broader vestibular assessment adds further measurement: tests of gaze stability, balance under varying sensory conditions, and caloric testing where an inner ear function deficit is suspected. Imaging is generally normal and is obtained to exclude other causes.

Why this meets the legal threshold

A provoked, observed and recorded physical sign is not a self-report, and it satisfies an objective-findings requirement in a way that a complaint of dizziness never will. Where the vestibular assessment also documents measurable deficits in gaze stability or balance, the record is stronger still. This is one of the few areas of post-concussion practice where the objective evidence is available if someone thinks to look for it.

Treatment and prognosis

Positional vertigo is frequently treated effectively with repositioning manoeuvres performed by a trained clinician, sometimes in a single session, and that responsiveness is itself diagnostic. It can recur, particularly after trauma. Other post-traumatic vestibular problems — deficits in gaze stability, persistent unsteadiness, sensitivity to visually busy environments — are treated with vestibular rehabilitation over a longer period, and some do not resolve completely. Persistent balance disturbance carries a real risk of falls and secondary injury.

How carriers attack this diagnosis

By attributing the dizziness to inner ear conditions unrelated to trauma, to medication, to blood pressure, to anxiety or to migraine. By pointing to normal imaging. By arguing that successful treatment with repositioning shows the problem was minor and is now resolved. And by characterizing continuing unsteadiness as subjective. The recorded positional testing answers the subjectivity argument directly, and documentation of recurrence answers the resolution argument.

Proving the accident caused it

Obtain formal vestibular assessment rather than relying on a general note of dizziness, and ensure positional testing is performed and, where possible, recorded. Establish the absence of prior vestibular complaints from the medical history. Establish the mechanism and the temporal relationship — onset following the injury rather than preceding it. Document recurrences and the functional consequences: falls, inability to work at height or to drive comfortably, avoidance of environments that provoke symptoms.

Available insurance coverage

What can be recovered is limited by what coverage exists. The at-fault party’s policy is the starting point, but it is frequently not the only source: the injured person’s own uninsured and underinsured motorist coverage, household policies, employer coverage where a vehicle was used for work, umbrella and excess layers, and the coverage of any additional responsible party can all apply. Underinsured coverage typically requires notice and consent before any settlement with the at-fault party — settling first can forfeit it. Identifying every available layer is early work, not closing work.

How damages are categorised and proven

Damages are not a single number that gets negotiated. They are separate categories, each proven by different evidence. Past medical expense is proven by billing records and the reasonableness of the charges. Future medical expense requires a physician’s opinion that the care is reasonably certain to be needed. Lost income is proven by employment and tax records; lost earning capacity is a different and larger question requiring vocational and economic analysis. Non-economic loss — pain, limitation, and the effect on daily life — is proven through the medical record and through testimony from people who can describe specific changes rather than general decline. No one can responsibly tell you what a case is worth before that evidence exists, and any figure offered at the outset is a guess.

Filing deadlines

Every injury claim is governed by a statute of limitations, and the periods differ by state and by claim type. For personal injury actions the period is two years in Virginia under Va. Code § 8.01-243(A), accruing at the date of injury; three years in Maryland under Md. Code, Cts. & Jud. Proc. § 5-101; three years in the District of Columbia under D.C. Code § 12-301(8); two years in New Jersey under N.J.S.A. 2A:14-2; and three years in New York under N.Y. C.P.L.R. § 214(5). These are general periods. Discovery rules, tolling for minors and incapacity, claims against government entities — the District imposes a six-month notice-of-claim requirement for claims against the District government — and claim-specific statutes can shorten or extend them. Do not rely on a general period for your own case; have the deadline confirmed on your facts.

Frequently Asked Questions

What is BPPV?

Benign paroxysmal positional vertigo — brief, intense vertigo provoked by particular head movements, caused by displaced calcium particles moving within the inner ear canals. It can occur spontaneously and it can be caused by head trauma. It is diagnosed by positional testing that provokes the symptom and a characteriztic involuntary eye movement.

How is it different from ordinary dizziness?

It is positional and brief — triggered by specific movements such as rolling over in bed, looking up or bending down — rather than constant. That pattern is what distinguishes it, and it is why the diagnostic examination reproduces the symptom deliberately. Other post-traumatic balance problems produce a more constant unsteadiness and are assessed differently.

Why is this useful evidence?

Because it produces an observable physical sign that can be recorded, rather than depending on the patient’s description. In a category of injury where carriers routinely argue that everything is subjective, a video-recorded positional test showing the characteriztic eye movement is objective evidence of a real physical condition.

My treatment worked after one session. Does that mean my claim is minor?

Not necessarily. Effective treatment demonstrates the diagnosis was correct rather than that the problem was trivial, and post-traumatic positional vertigo commonly recurs. It is also frequently accompanied by other vestibular deficits that repositioning does not address. Document recurrences and any continuing unsteadiness rather than treating the first successful session as the end of the matter.

Can a head injury cause balance problems without BPPV?

Yes. Trauma can affect gaze stability, central processing of balance information, and tolerance of visually complex environments, producing persistent unsteadiness and discomfort in places like supermarkets or busy streets. These are assessed through broader vestibular testing and treated with vestibular rehabilitation over a longer course.

Who should assess me?

A clinician trained in vestibular assessment — commonly an audiologist, a neurologist, an ear, nose and throat clinician, or a vestibular physical therapist. The important thing is that positional testing is actually performed and documented, because a general note recording dizziness is not evidence in the way a positive provoked test is.

How does this affect daily life?

More than people expect. It can prevent driving comfortably, working at height or on ladders, and operating machinery. It causes falls, which produce further injury. It leads people to avoid environments that provoke symptoms, which narrows daily life. These consequences should be documented specifically rather than summarised as dizziness.

How long do I have to bring a claim?

Two years in Virginia and New Jersey, three years in Maryland, the District of Columbia and New York for personal injury actions, subject to tolling and discovery rules and to shorter notice periods where a government entity is involved. Have the deadline confirmed on your own facts.

About Mr. Sris

Mr. Sris is the owner and founder of Law Offices Of SRIS, P.C., which has practiced since 1997. He is a former prosecutor and is admitted in Virginia, Maryland, the District of Columbia, New Jersey and New York. Of Counsel attorneys contract directly with the firm and handle matters alongside him. In 2019 Mr. Sris testified before the Virginia House Courts of Justice Committee on House Bill 635.

Speak with Mr. Sris

Injury claims are governed by filing deadlines that vary by state and by claim type, and evidence degrades quickly. Request a consultation. Reach our location at (888) 437-7747. Consultations are by appointment.

Last reviewed: August 22, 2026.

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