Learn what to expect after suffering a work-related back injury. We provide examples of workers’ comp back injury settlements and calculations.
A back injury is one of the most common workplace injuries in the United States. It can also be among the most debilitating. Inability to walk or stand and chronic pain are among the serious issues suffered by injured workers.
Depending on your job and the extent of your injury, you could be limited in the way you perform your duties. You could also be prevented from doing your job altogether.
American workers are protected by the workers’ compensation system in each state. This system was set up so injured people could get quicker compensation for workplace injuries without having to prove their employer’s negligence.
This article discusses the workers’ compensation settlement process for back injuries. We’ll look at common types of work-related back injuries and examples of average settlements. We’ll also talk about permanent disability benefits in back injury cases.
Back Injuries in Workers’ Comp Cases
Work-related back injuries include a wide variety of conditions like herniated discs, a broken back, sprains, and more.
Though a workers’ compensation claim may not take as long as a lawsuit against your employer, getting a proper back injury settlement from workers’ comp can be challenging.
Workers’ compensation insurance companies are notorious for rejecting back injury claims. Some states, like Virginia, only cover back injuries from specific events. If you carried boxes all day, and can’t straighten up the next morning, you won’t be covered.
Sometimes, the claim process is complicated enough to warrant hiring an attorney. You’ll also likely have to decide at some point whether to settle your claim and for how much.
Herniated or Bulging Disc (Slipped Disc)
One of the most common and painful lower back (lumbar) injuries that people suffer at work is a herniated disc. The “discs” are cushions between the bones of your spine. Lifting heavy objects, twisting your back or falling can cause a disc to slip out of place. The result is often severe back pain, tingling, numbness, and reduced ability to move, lift or carry.
Lower back injuries often happen in physically demanding professions, like construction workers or warehouse workers, though they can also happen in places like offices when moving boxes or equipment.
Workers’ comp insurance companies may tell you that slipped discs are not that serious, and that in 90% of cases the pain will go away within six weeks. While that may be true, it’s estimated that in 10% of cases the pain is unlikely to go away on its own.
Getting a better settlement for lower back injuries will hinge on being able to explain why your case is one of the 10% that continues to linger. You may also need to prove your lower back pain is not from a pre-existing condition.
Fractured Vertebrae (Broken Back)
Falling, twisting, or impact from a vehicle can all result in a fractured spinal column. Fractured bones in your back can be extremely painful and require serious medical treatment. You may have to wear a brace for as long as three months. You might also need surgery and months of physical therapy to get back to your pre-injury condition.
In a workers’ compensation claim involving a broken back, it’s very important to limit your physical activity so you don’t make the injuries worse. This may require more time away from work, which should be considered in any settlement.
You may need lots of medical evidence to document the exact nature of your fracture and why the extra time away from work is necessary.
For example, the insurer may take the position that, because you work in an office, you can return to work while your back heals. This may not be a viable option for you, though, if the bones of your back are fractured in such a way that sitting in a desk chair might prevent healing or actually make your injury worse.
Here, your doctor would need to explain why sitting in a desk chair for eight hours could make your injury worse, so returning to work immediately is not an option.
Spinal Cord Damage and Paralysis
One of the worst types of back injury is damage to your spinal cord. This can happen when your spinal cord is crushed or cut in a fall or other traumatic accident. Spinal cord injuries can be painful and deadly. It can also leave you permanently paralyzed.
Because these injuries often result in severe disability, they’re more difficult to resolve through settlement. In addition to the typical medical records and doctor testimony, you may also need to demonstrate the challenges presented by your spinal cord injury in a more human and relatable way. Photos, videos, and testimonials can help get the settlement discussion where it needs to be.
Average Back Injury Settlement Amounts
Across all workers’ comp claims for all types of injuries, the average claim comes to $41,003, according to the National Safety Council.
That same data set states average costs of $36,882 for lower back injuries and $33,154 for upper back injuries. When you go through the workers’ compensation system, you cannot recover an amount for pain and suffering.
The seriousness of your condition, as well as the required medical treatment and prognosis, makes a big difference in the value of your claim. What is considered an “average” or “favorable” settlement will vary based on your exact back injury. A broken back is always going to be more serious than a muscle sprain, and thus it’ll have a higher value.
Workers’ comp wage benefits are about two-thirds of your average pre-injury income. Similarly, a workers’ comp back injury settlement will use the wage benefit calculation.
Workers who suffer a permanent partial disability or total disability from their back injury may be eligible for a lump sum settlement based on a state or federal “schedule” of benefits allocated for each body part or function.
Workers’ compensation back injury settlements can take between one and two years to resolve. More complicated or expensive claims may take longer.
For your protection, many states require workers’ comp settlements to be approved by a judge or the state’s workers compensation commission.
Example: Herniated Disc from Heavy Lifting
Greg makes $15/hour working in the copy center of an office building. While trying to move a copier at work he felt something “pop” in his back. He’s suffering severe pain from a herniated disc and has been out of work for six weeks. After trying less invasive treatments, his doctor has concluded that he needs surgery, after which he will need four more weeks to recover.
Prior medical expenses: $5,000
Cost of surgery (average cost between $20,000-$50,000): $35,000
10 weeks of lost earnings (66.6 % of $563 week = $375): $375 x 10 = $3,750
Estimated Settlement Value: $43,750
Greg was able to link his back injury to a specific event at work. A CT scan of his back pinpointed the disc damage. Just as important, his doctor’s notes verify the medical necessity for Greg to stay out of work until he heals from surgery.
Example: Broken Back Requiring Surgery
Shannon works at a hotel in New York City making $18/hour. She slipped and fell at work two weeks ago and broke two lumbar vertebrae in her lower back. Her doctor has determined that the fracture will not heal on its own, and that she needs spinal fusion surgery. She has been out of work for two weeks already, and will need about five more months to recover after surgery.
Prior medical expenses: $5,000
Cost of surgery ($24,000-$66,000): $45,000
24 weeks of lost earnings (66.6 % of $720/week= $479.52): $479.52 x 24 = $11,508
Estimated Settlement Value: $61,508
Example: Permanent Disability from Spinal Cord Injury
Carson works as a janitor in a federal courthouse in Los Angeles. He makes $18.75 per hour, or $750 per week. Carson slipped and fell at work, re-injuring his back after a previous bad fall two years ago.
This time, when he broke the bones in his back, they damaged his lower spinal cord and resulted in paraplegia. Due to his paralysis, he can no longer work his federal job.
Federal workers are covered by the Federal Employees Compensation Act (FECA).
FECA allots 288 weeks of benefits for an employee who lost the use of one leg, so that will be doubled since Carson lost the use of both.
Medical expenses (past and future): $518,000
Base benefit for lost wages (66.6% of $750): $499.50
Period of time of benefits for a lost leg: 288 weeks (multiply this by 2 to account for both legs): 576 weeks
Fair settlement of lost earnings: ($499.50 x 576) = $287,712
Estimated Settlement Value: $805,712
The Value of Lifetime Medical Benefits
In some states and situations, you can either settle your workers’ compensation claim for a lump sum or receive lifetime benefits, but not both. It’s important to understand the law in your state and whether you give up lifetime medical benefits when you settle.
The benefits to a lump sum would be that you can get the money upfront and invest or spend it as you choose. You couldn’t, however, come back and ask for more if you develop complications later in life.
In the case of permanent total disability, lifetime benefits may be the safer choice. You should talk to a workers’ comp lawyer before making this decision.
For lifetime benefits, the workers’ comp insurance company must agree the injured worker is permanently disabled. Assuming that the insurer agrees, the person’s medical bills and costs would be covered as they occur, though payment would probably not be available in a lump sum.
Get Back on Track After Your Back Injury
It may be easier than a lawsuit against your employer, but a workers’ compensation claim can still be complicated. This is even more true where you suffer permanent disability or have ongoing medical issues. Especially in those cases, you should have an experienced workers’ compensation lawyer on your side.
If you or a loved one suffered a work-related injury and you’re considering a back injury claim, you need to start right away. Time limits apply, and you don’t want to risk losing benefits.
Contact a qualified workers’ compensation attorney today for a free consultation and case evaluation.
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