Although often associated with sports, rotator cuff injuries are a relatively common result of car accidents as well. Rotator cuff injuries (especially ones requiring surgery repair) can be painful and debilitating.
If you or a loved one has had rotator cuff surgery after a car accident you may be wondering what’s your claim worth? In the following article, we’ll delve into the topic in detail to ensure you’re not navigating the claim blindly and ultimately get a fair settlement.
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How Does a Car Accident Cause a Rotator Cuff Injury?
According to the American Association of Orthopaedic Surgeons (AAOS), a rotator cuff injury most commonly takes the form of a tear in one of the muscles, tendons or ligaments that surround the shoulder joint (known as the rotator cuff) .
The exact method by which a car accident causes a rotator cuff injury can be complicated. But the shoulder often ends up in an unnatural position and absorbs the force of a motor-vehicle accident.
This impact can easily cause a tear, especially in the case of rear-end accidents or one where a person has tried to brace themselves.
Insurance companies often try to dispute claims involving rotator cuff injuries by stating they are due to preexisting conditions or degenerative processes. Get your doctor or surgeon to write a letter indicating the likely origin of the injury, this will help to head off this issue.
What Are the Symptoms of a Torn Rotator Cuff?
If you’ve been down this road and had rotator cuff surgery already you’ll be intimately familiar with the symptoms. But for anyone earlier in the process, the most common symptoms (per WebMD) are :
- Dull ache or pain in the shoulder area.
- Difficulty raising your arm above your head.
- Muscle weakness and lost range of motion.
- Swelling or stiffness in the shoulder.
- A clicking or popping sound when moving your arm.
- Sleep disturbances, being unable to put pressure on the affected shoulder.
The good news is that rotator cuffs can be treated very effectively. Minor injuries can be dealt with physical therapy, rest and corticosteroid injections. Injuries that don’t respond to these treatments often require surgery.
Filing a Claim for Your Rotator Cuff Surgery
Any claim involving surgery is obviously going to cost a bit more than average and because of this, it will be scrutinized more closely by an insurance company.
Many insurance companies will flatly deny these type of claims and really make you work to prove it. Be sure that at the onset you don’t give a recorded statement or sign a release with the other party — this can jeopardize your ability to be compensated later.
Let’s assume fault is clear (it’s not yours). So your biggest challenge in terms of your claim is going to be two things.
- Linking your injury to the accident
- Proving that no preexisting condition affected your injury
The best thing you can do to achieve these goals is to seek medical treatment immediately after an accident. It also helps to get your attending physician on the record about the causation of your injury. Most doctors will be used to this and happy to oblige.
This is imperative to do quickly because it allows you to demonstrate that the cause of your injury (and resulting surgery) is due to the accident. In many cases, an attorney is required to make sure you receive fair compensation.
How Much is Your Claim Worth?
Estimating the value of any claim is an imperfect science at best, and rotator cuff claims are no different.
According to one source, the average cost of rotator cuff surgery repair in the US is $21,800 . This does not include additional costs including physical therapy, medications or follow-up visits.
Beyond the statistics, there are a number of other factors which can significantly affect the value of your claim. A few of these are:
- Was your accident with a passenger vehicle or a commercial one? Policy limits can vary quite a bit between these two.
- Did you immediately seek medical treatment? The quicker you were treated the better the odds your claim will be accepted and paid in full.
- Did your injuries prevent you from returning to work? If your job is physically demanding lost wages can add up quickly, not to mention permanent diminishment of earning potential.
- What does the police report say? This will play a big role in determining fault, a key component of how your claim plays out.
- Would the other party likely be found liable in a trial? The value of your claim goes up considerably if it’s clear the other party was in the wrong.
Another way try to ballpark your claim is to review comparable cases and check the corresponding settlement amounts. Here are a few examples:
Example 1 — MarylandDriver A is turning off of a major road but yields to a pedestrian in the crosswalk when she is rear-ended by driver B. She injures her rotator cuff and it requires surgical repair. She misses some time from work but is not given any permanent impairment rating. Her settlement: $250,000.
Example 2 — MichiganDriver A is rear-ended by driver B. Driver A tried to brace on the steering wheel and tore his rotator cuff. After surgery, he sought damages from the other driver (who was uninsured) and his UIM coverage. Both parties contended driver A caused the accident by slamming on his brakes. His settlement: $65,000.
Example 3 — TexasDriver A (a 56-year-old construction worker) was stopped at a red light, driver B was looking at her cell phone and failed to brake in time slamming into the back of driver A.
Driver A required arthroscopic rotator cuff repair surgery and extensive rehab. Driver A sued driver B for medical costs, lost wages, diminished earning potential (he was unable to go back to his job) and pain and suffering. His settlement: $689,000.
Although they are not as common as some other types of car accident injuries, torn rotator cuffs can absolutely be the result of a car wreck. To review:
- Rotator cuff tears occur when the muscles, ligaments or tendons around the shoulder socket are damaged. The blunt impact of an accident can cause this type of injury.
- A dull ache, muscle weakness, and reduced range of motion are the primary symptoms of rotator cuff tears.
- Approaching a rotator cuff claim is challenging and be prepared for the insurance company to fight you. Enlist the help of an attorney if needed.
- The average cost of rotator cuff surgery is around $21,000, but there are a lot of other factors which affect claim value. Primary among them are the severity of injury, fault in the accident, preexisting conditions, and available policy limits.
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