HQ BaselinePolicy & law
Your Coach Can't Clear a Concussion: Who Actually Has Legal Authority in Return-to-Play Decisions
A point of confusion — and sometimes conflict — in youth sports.
This is a point of confusion — and sometimes conflict — in youth sports: who has the legal authority to clear a concussed athlete to return to play?
What the law says
In every state with a concussion law, the answer is consistent at its core: a licensed healthcare provider must provide written clearance. But the definition of “licensed healthcare provider” varies significantly across states. According to the National Conference of State Legislatures, some states restrict clearance authority to physicians (MDs and DOs) specifically trained in concussion management. Others allow nurse practitioners, physician assistants, and athletic trainers. A smaller number include broader categories of licensed healthcare professionals.
What no state allows
What no state allows is clearance by a coach, parent, athletic director, or the athlete themselves. Yet research suggests this happens routinely in practice, particularly in youth sports settings without athletic training coverage. A study published in the Journal of Safety Research (2021) found that parent and youth athlete concussion knowledge remains limited despite legislative efforts, with many parents unaware of the clearance requirements in their own state.
Even more concerning, a qualitative study published in PMC documented a case in which a parent deliberately withheld concussion information from a coach so their child could continue playing. This behavior — while understandable from a competitive perspective — directly undermines the legal protections designed to keep the athlete safe.
How baseline data supports the clearance decision
At Headquarters, we provide baseline and post-injury testing that supports the clearance decision made by qualified healthcare providers. Our reports are designed to be interpreted by physicians, neuropsychologists, and athletic trainers with concussion management training — and include all the data they need to make an informed, evidence-based return-to-play decision. For state-by-state context, see concussion laws in all 50 states.