Learn how to calculate a workers’ compensation knee injury settlement. We review examples of common work-related knee injuries and average payout amounts.
Your knees are critical for maintaining your mobility and independence. Knee injuries can lead to decreased mobility and in some cases the complete inability to walk. A variety of conditions in the workplace can lead to knee injuries.
Whether we suffer a slip and fall accident in the office kitchen or an industrial accident in a warehouse, a knee injury can put us out of commission for weeks or months. It may even lead to a lasting disability that keeps us from working.
This article looks at work-related knee injuries and workers’ compensation claims. We’ll examine common types of knee problems and their treatment, the workers’ compensation claim process, and what you might expect from an insurer for a work-related knee injury settlement.
Settlements for Work-Related Knee Injuries
The adjuster at a workers’ compensation insurance company will have seen many knee injuries like yours, and will know the approximate lump-sum settlement value.
Thus, you need to arm yourself with the same kind of knowledge. It helps to retain a qualified workers’ compensation attorney in your state with experience in workers’ compensation settlements.
The kind of medical treatment you need will be the primary driver of your workers’ comp settlement amount. Because knee surgery is so expensive, the need for it will almost always increase the value of your injury claim. Other common medical expenses include medication, physical therapy, and cortisone shots.
Average Knee Injury Settlement Ranges
A knee injury that can be fixed with light physical therapy and medication might settle for somewhere between $10,000 and $20,000.
Different kinds of surgeries can increase the value in different ways. Surgery to repair a broken patella (kneecap) can easily raise the economic value of a claim above $50,000 when disability benefits are added to the mix.
On the other hand, surgery for a torn anterior cruciate ligament (ACL) and the associated medical care may raise the value of a workers’ compensation claim to $80,000 or more.
As you read the examples below, keep in mind that workers’ comp claims do not include pain and suffering in the same way that a settlement for a civil personal injury case would. Thus, these average settlement amounts will be lower than the amounts in a standard personal injury case.
Broken or Dislocated Kneecap Injury
The patella, more commonly known as the kneecap, sits at the front of your knee and covers the joint. Its underside is covered with cartilage that helps your knee’s various muscles and bones move smoothly as you walk. It also protects your knee joint from violent impacts and injuries.
It is this protective placement of the patella that makes it vulnerable to injuries. Often, when people trip and fall they fracture their patella when landing on their knees.
Patella fractures can make movement of the knee excruciatingly painful and even damage the delicate tendons in the knee, sometimes requiring surgery to put everything back where it belongs.
Even if a patella isn’t fractured, it can still be dislocated. Here, even though the bone itself is not broken, the muscles and tendons around it may be stretched or torn. Though dislocations often do not require surgery, that can change if the damage to the surrounding tissue is bad enough.
Workers’ comp wage replacement benefits are typically two-thirds of pre-injury income. In our examples, we’ll multiply the victim’s pre-injury wages by 0.67 to get an estimated wage benefit.
Example: Office Fall Causes Broken Kneecap
George works in the information technology department of a large accounting firm in Las Vegas, Nevada. He makes $20 per hour. He works in an area with a number of cubicles.
One of his co-workers plugs in a laptop across the walkway near George’s cubicle. As he is coming back from the restroom, George fails to see the cord in his path and trips over it. He lands on his right knee, and the pain is immediate and sharp.
He is taken to the hospital, where x-rays show that he broke his patella in two places. The edge of the broken bone has also partially cut through some of the tendons around his knee. George will need surgery to repair the damage.
Due to the surgery and severity of his fracture, George will be out of work for four months while he recovers.
Medical treatment: (hospital, doctors and medical imaging) $5,000
Lost wages benefit: ($800 per week × 16 weeks × 0.67) $8,576
Surgery: $30,000 (note: a total knee replacement surgery would likely increase this amount to $50,000)
Physical therapy (3 times per week for 4 months): $9,600
Estimated workers’ comp settlement value: $53,176
Torn ACL Knee Injuries
Your ACL is a crucial knee ligament that enables your knee to move back and forth. Damage to the ACL can happen when there is a severe impact to the knee. It can also happen as a result of repetitive stress or certain types of continuous movement.
If you suffer an ACL injury as a result of a workplace accident, chances are that you will not be able to walk properly. You may not even be able to put weight on the affected leg.
Surgery for ACL injuries has advanced considerably, with arthroscopic surgery available for less serious cases. Open surgery is still used in some cases, though, and it can cost as much as $50,000.
Example: Torn ACL from Construction Accident
Madge is a construction worker in northern California where she earns the average weekly wage of $680, or $17 per hour. As part of her job moving lumber and other building supplies, she and her co-workers often use forklifts. One day, while Madge was at a work site, her co-worker lost control of a forklift and drove it into Madge’s left leg.
Madge was rushed to the emergency room. Tests showed that Madge suffered not only a fracture, but a torn ACL. Due to the speed and force of the impact on her knee, Madge will need open ACL surgery. She will not be able to walk or do her job for at least 6 months.
Past medical bills: (hospital, doctors and medical imaging) $5,000
Lost wages benefit: ($680 per week × 16 weeks × 0.67) $7,289.60
Physical therapy: (3 times per week for 6 months) $14,400
Estimated workers’ comp settlement value: $76,690
Understanding Workers’ Compensation Settlements
Workers’ compensation benefits do not cover the full amount of an injured employee’s wages. Wage replacement disability benefits typically cover about two-thirds of the injured worker’s average weekly wage. Worker’s comp will not compensate you for pain and suffering.
Workers’ compensation programs provide immediate medical care for eligible employees and partial wage replacement. The trade-off is that an injured employee cannot sue their employer except in extreme circumstances.
You may be able to file a personal injury lawsuit against your employer if your workplace knee injury was caused by intentional or egregious negligence. In a personal injury lawsuit, you can seek compensation for all your damages, including your full wages and emotional distress.
Medical Benefits and Knee Injury Settlements
Workers’ compensation insurance will only cover reasonable and necessary medical costs for your knee injury. Your treating physician must document the need for surgery, and justify the amount of time you will be unable to work.
Depending on your state’s workers’ compensation laws, chiropractic care or “alternative” treatments may not be covered by your employer’s workers’ compensation insurance.
Before settling your workers’ compensation case for a lump sum, it’s important to accurately calculate future medical expenses and include those expenses in the final settlement amount.
Most insurance companies will want you to waive future medical care as part of the settlement. If you waive medical benefits, the cost of any future medical care for your work-related injury is your responsibility.
Disability Wage Settlement Schedules
Your work-related knee injury may have left you with a degree of permanent damage to your knee. In workers’ comp terms, you are left with a permanent partial disability.
Federal and most states’ workers’ compensation programs use a loss-of-use schedule of injuries to calculate permanent disability settlements. The schedule allocates a specific number of wage benefit weeks for each body part or function.
A scheduled settlement award can be requested after you’ve reached maximum medical improvement (MMI). In other words, your doctor says your knee won’t get any better with treatment. Your doctor will then give you an impairment rating between 10% and 100%.
For example, using the New York State’s Loss of Use Schedule, the maximum award for a knee/leg injury is 288 weeks.
The settlement is calculated by using the worker’s weekly wage benefit and the medically determined impairment rating. If you have a 25% impairment rating, you would get 72 weeks of wage benefits. Let’s say your workers’ comp weekly wage benefit is $800. The wage portion of your workers’ compensation settlement would be 72 x $800 = $57,600.
Getting Back on Your Feet
Even a relatively minor workplace injury, like a knee strain or sprain, can seriously disrupt both your personal life and your career for a number of weeks.
If you suffer a work injury to your knee, it’s important to make a worker’s comp claim as soon as possible. If you don’t, you risk losing the right to get any compensation under your state’s laws.
If you or a loved one has suffered a serious knee injury while at work, you need to know how to maximize your workers’ comp benefits. Most injury attorneys offer a free consultation. Don’t wait to seek legal advice from a qualified workers’ comp lawyer for your knee injury case.
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