HQ BaselinePolicy & law
When State Laws Protect Athletes but Abandon Workers: The Policy Double Standard on Brain Injuries
A conspicuous and indefensible double standard in U.S. brain injury policy.
The policy landscape for brain injury protection in the United States has a conspicuous and indefensible double standard.
What athletes and service members have
All 50 states mandate concussion protocols for youth athletes. The military now mandates cognitive baselines for all service members, per the 2024 DOD directive. Professional sports leagues invest millions in multi-layered concussion management programs.
What civilian workers don’t
But zero states and zero federal agencies require concussion baseline testing, standardized concussion management protocols, or return-to-work clearance requirements for civilian workers in any industry — despite the CDC’s finding that 24% of all TBIs are work-related.
Construction workers, miners, oil rig operators, manufacturing workers, first responders, and countless others face daily head injury risk with no mandated protections equivalent to what a 14-year-old soccer player receives under state law. There is no OSHA concussion standard. There is no requirement for employers to implement return-to-work protocols after a head injury. And there is no data collection system tracking workplace concussion incidence, management, or outcomes at the federal level.
Who’s tracking this gap
This gap has been noted by occupational health researchers. The National Institute for Occupational Safety and Health (NIOSH) has published guidance on TBI prevention in the workplace but has not proposed regulatory standards. The American College of Occupational and Environmental Medicine (ACOEM) has called for greater attention to workplace concussion but does not mandate baseline testing in its guidelines.
What we advocate for
At Headquarters, we advocate for extending concussion protections to all populations at risk. Until policy catches up, we provide workplace baseline programs that give workers and employers the same level of brain health documentation that athletes have had for two decades. See our companion pieces on construction workers and brain protection and the workers’ comp value of baselines.