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Average Settlement Amounts For Spinal Fusion Claims



The impact of a car accident can put a lot of stress on your spine, particularly in the lumbar or lower section of your back. There is a host of injuries that can occur because of this and a wide range of corresponding treatments.

One of these treatment options is spinal fusion surgery. If you've been injured in a car accident that required this procedure you're likely wondering what the average settlement amounts for spinal fusion claims are.

In the following, we'll dig into the details so you can properly valuate your claim and ultimately receive a fair settlement.

What is Spinal Fusion Surgery?
What Type of Injuries Create the Need for Spinal Fusion?
Does Spinal Fusion Qualify me for Disability?
How Much is Your Spinal Fusion Claim Worth?

Let's get started….

What is Spinal Fusion Surgery?

If you've already had the surgery you're undoubtedly well versed in what spinal fusion (also called “arthrodesis) is. For everyone else:

Spinal fusion is a surgical procedure used to correct problems with the small bones of the spine (vertebrae). It is essentially a "welding" process, the goal being to join two bones together to reduce pain and increase function [1].

In a spinal fusion procedure, doctors collect a bone graft from another area of your body (or donated) to connect the vertebrae of the spine. They sometimes also use rods, screws or plates to hold things together until the bone can heal.

This is invasive surgery that can seriously affect your quality of life (good or bad). It typically requires a long recovery, use of a back brace and extensive physical therapy. Doctors tend to use it as a last resort.

What Type of Injuries Create the Need for Spinal Fusion?

The dynamics of back injuries during a car crash are complicated. But one thing's for certain, the human back/neck was not well designed to sustain the jarring impact of a crash.

Spinal fusion surgery is undertaken for a variety of different reasons, some of the most common ones are:

  • Disc herniations
  • Fractures of the vertebrae
  • Discogenic pain
  • Degenerative processes
  • Arthritis or scoliosis

When it comes to car accidents, the two primary causative factors leading to a fusion are herniated discs and fractures. According to Spine Health, the most common indication for spinal fusion is back pain that lasts more than 6 months and does not respond to standard therapies [2].

Does Spinal Fusion Qualify <e for Disability?

Spend a few minutes googling and you'll quickly see spinal fusion often mentioned in the same breath as disability. But simply undergoing this procedure does not guarantee you qualification for social security disability payments.

To qualify you need to meet the requirements listed in the “blue book”, a guide used to determine if someone is medically disabled. If you match some of the impairments listed there you can automatically qualify.

The blue book says that to qualify:

  • You must have a disorder of the spine, such as spinal stenosis, degenerative disc disease, arthritis, osteoarthritis, or vertebral fracture, and
  • The disorder affects the nerve root or the spinal cord in a tangible way.

Also, there is another list of issues and associated problems. You must demonstrate that at least one applies to you.

  • Compression of the spinal nerve or root
  • Sensory or reflex loss
  • Inflammation of the spinal membranes
  • Severe pain or sensitivity (causing you to constantly change positions)
  • Narrowing of the spinal canal (stenosis), difficulty functioning normally

Whether or not you are eligible for disability depends completely on whether or not your situation matches these (and further) criteria.

Now that we've covered some basics, let's discuss getting a settlement amount for your spinal fusion claim.

How much is Your Spinal Fusion Claim Worth?

The value of your claim is going to fall into two categories.

  1. Hard costs such as the price of the surgery, medications, physical therapy and time missed from work.

  2. You may also have a legitimate pain and suffering or loss of consortium claim, which is a bit more abstract but makes up the second category.

Spinal fusion claims that arise from spinal cord injuries are compensated highly due to their potentially serious consequences. This is especially true of ones involving a damaged nerve root or other complications.

National (US) average costs for spinal fusion surgery runs between $14,000 and $26,000 [3]. This does not include extended hospital stays, follow up treatment, medical accessories, medications and other associated costs. There are quite a few anecdotal reports of surgeries costing $50,000 or even $70,000.

Beyond the basic medical costs, some other factors which may affect the value of your claim are:

  • Liability -- Was the other party in the accident clearly at fault? Is their insurance company disputing the claim? This can play a big role in the amount you receive.

  • Permanent impairment -- Sometimes even a successful surgery will lead to permanently reduced capacity to function. This matters enormously to your overall claim value.

  • Claim or lawsuit -- If you handle your claim through your (or other parties insurance company) and don't file a lawsuit this may affect the settlement as well. Lawsuits tend to garner higher settlements but they also incur attorney fees.

  • Preexisting conditions -- if you have preexisting conditions that affect the need for spinal fusion surgery, this can diminish your claim value.

Lastly, let's run through a few real examples to help you ballpark your claim.

Example 1 -- California

Driver A was rear-ended as he was taking a left hand turn by Driver B. Fault was clear and Driver A needed cervical fusion surgery following the accident. He was a public utility worker and was unable to return to work after the procedure. His settlement: $537,000.

Example 2 -- Minnesota

Driver A (26-year-old man) was struck by driver B who had made an illegal U-turn. Driver A suffered a herniated L1-S5 disc which required two surgeries (including a fusion), and there was substantial damage to his Ford Bronco. His settlement $775, 282.

Summary

Spinal fusion claims are serious and typically involve a much higher dollar amount than other claims. Because of this people often seek the counsel of an attorney. But even if you are represented it's good to educate yourself. Keep in mind:

  • Spinal fusion surgery is a medical procedure whereby two bones are joined together to promote stability and reduce pain.

  • Spinal fusion procedures are usually indicated for displaced discs, spinal fractures or chronic back pain.

  • Having a spinal fusion done may qualify you for disability payments, check your specifics against the blue book to find out.

  • The true cost of your claim is going to come down to the severity of your medical situation, the liability involved and how you approach the claim.


Sources

1 - American Academy of Orthopaedic Surgeons
2 - Spine Health
3 - Wolters Kluwer


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