Suffering a back injury at work comes with more than physical discomfort or pain as there are significant medical bills and other financial factors to keep in mind. Whether you sustain a back injury from working on a physically demanding task or lifting an object in your workplace, it can be debilitating and painful, and you may also need to get treatment.
Fortunately, when you injure your back in a work accident, it is highly likely that you will be able to apply for a workers comp settlement for a back injury.
Usually, the average settlement amount for work-related back injuries will significantly differ depending on the type of injury sustained. Spinal injuries are normally associated with high settlement amounts, which means that such cases may require millions of dollars to settle. Besides, back injuries that result from negligence are taken very seriously, and a lawsuit against the responsible party will, in most cases, lead to a settlement.
What is Workers Comp Settlement?
When you sustain a work-related injury that prevents you from working, you may get permanent disability benefits by filing a workers’ comp claim. Depending on the severity of the injury, the location, and other factors, you will receive weekly checks for a given period.
However, many states will also allow you to choose a settlement as a structured settlement or one-time payment rather than weekly benefits. When you agree to take the settlement offered, you may lose the right to pursue additional benefits through workers’ compensation.
Pros of a Workers Comp Settlement
- It enables you to avoid a trial. Proceeding to trials can be tricky as the jury may decide to reduce your benefits.
- It allows you to negotiate and receive the money if you decide to let go of your future benefits. For instance, if there is a possibility that you may need back surgery, you can negotiate and receive part of the medical cost with your settlement.
- Allows you to save time and anxiety that comes with the trial process and hearings
The downsides of workers comp settlement:
- Managing a lump-sum payment can be a challenge. You are likely to be left without weekly payments if you spend what you receive as settlement very quickly.
- Accepting a settlement can be quite risky as you lose your right to pursue additional benefits. Therefore, if there are additional medical expenses or if you require ongoing treatment or your condition worsens, the settlement may not be enough to meet your medical expenses and normal bills.
Types of Workers Comp Settlement
When you file a workers comp claim, there are a few things that are likely to happen. First, the workers’ comp insurance may decide to pay for treatments after filing the claim. The pay could be doctor visits, physical therapy, lost wages, medications, or disability coverage in case of severe injuries.
The insurance companies may decide to offer a settlement amount that they feel is fair for your damages. However, if you feel that the payout they propose should be more, you can negotiate for a higher payment sum. If you agree on the payout, you will decide how the settlement will be paid out to you.
In this case, the injured employees can choose a structured approach that involves a plan where the total amounts are spread over monthly payments. In some cases, the insurer or employee may avoid making payment after a claim and argue that the injury was not fully work-related. If this happens, you will have to argue your case, mainly with the help of a personal injury lawyer through an appeal process.
What excuses might the insurance company use to oppose my claim?
Workers’ comp settlement amounts for injuries are likely to be denied at first. Besides, insurance companies use various delay tactics and some factors when denying or awarding compensation for back injuries. Some of the common excuses that insurers give when denying workers comp payout include:
- Failure to meet a deadline when filing a claim
- Pre-existing injury
- The injury did not justify compensation since it was not serious enough
- The injury did not result from the work-related activity
- Claim that the injury was fabricated
Fortunately, other employer excuses like “your injury resulted from your own fault” do not work against defenses on workers’ compensation claims. Such excuses are also easy to handle since we have heard them many times over.
What is the average work comp settlement?
When it comes to the work comp settlement, there are various factors that determine the amount that the employee will receive as a settlement. The average employee receives about $20,000 for work comp settlement payout, but the usual range is between $20,000 and $40,000.
The above range may appear huge, but the injuries that get a workers comp settlement greatly differ in terms of the lost wages and the amount that requires compensation. Moreover, there are also ways that can help you get a higher settlement in back injury claims.
After the settlement is offered, the employee still has an option to ask for better terms and payout amount. Usually, if you accept the first offer that the insurer or employer offers, you will get a much less amount than if you decline and ask for a high workers comp payout amount.
Workers’ Compensation: Verdicts and Settlements
John W. Smith
John, an ironworker, suffered a severe injury while in his line of duty, which led to a complex case. After months of myriad medical and insurance issues, the case was settled in his favor, and he was able to receive $12,000,000. The insurer provided him with workers’ compensation insurance funds offered him and his family a vehicle and a handicap-accessible home.
Michael Fox, Texas
Michael (an Assistant Project Manager for a petroleum company in Texas) fell while on a site and suffered a back injury surgery that required surgery to treat. Consequently, he received a workers’ comp settlement for back injury of up to $425,000 and a $485,000 Medicare Trust also established for him.
Emma (an ironworker) suffered a serious injury that required surgery. After the surgery and vocational rehabilitation, she found suitable employment. She received a $275,000 settlement that included $10,000 as a cover for medical expenses.
Is My Job Putting Me at Greater Risk of Sustaining Back Injuries?
Work-related back injuries happen in all industries and occupations, but there are job duties that increase the risks. Here are some of the job duties that have the highest number of work-related back injuries:
- Carrying or lifting heavy items (weighing over 25 pounds)
- Driving heavy machinery or motor vehicle
- Operating heavy equipment such as an excavator or crane
- One-arm work that may cause muscle imbalance
- Pulling and pushing machines, equipment, or carts
- Working at heights, including roofs, scaffolds, and ladders
- A job that involves restraining inmates, patients, or the general public
- Duties that involve awkward postural movements such as kneeling, bending, climbing, squatting, or crawling
- Filling orders or stocking shelves at a warehouse or distribution center
What are the Common Back Injuries in a Workplace?
Many back injuries result from work-related duties, but the type of the injury is not as important as the disabling nature of the pain and recommended treatment when it comes to workers comp cases. Nevertheless, the diagnosis helps you understand what to expect in your settlement for the back injury.
These injuries fall into different categories, including:
Lumbar Strains and Sprains
Back injuries involve damages to the tendons, ligaments, and muscles holding the spine in place. Injuries to the tendons and muscles are known as strains, while ligament injuries are sprains.
The two types of musculoskeletal impairments are common in the workplace back injuries. Sprains and strains are called “lumbago” when they do not come with radiating pain.
Back sprains can be classified into the following groups:
- Grade I: A grade I lumbar sprain results in limited functional loss, which means that it is the least severe of all types of back strain.
- Grade II: A grade II lumbar strain may result in some functional loss and some pain within a given range of motion.
- Grade III: A grade III lumbar strain results in structural instability and complete ligament tearing. This type of sprain may require surgery as it results in functional loss.
Lumbar Strains Classification
Back strains can be categorized into the following groups:
- Grade I: A grade I lumbar strain results in limited functional loss and minor muscle damage. It is the least severe and has no bruising or swelling.
- Grade II: A grade II lumbar strain might be characterized by limited use for some time but with a good prognosis. The back strain can lead to some muscle tissue damage with bruising, tenderness, and swelling.
- Grade III: A grade III lumbar strain results in complete muscle tearing, swelling, and tendon function or strength loss. This type of back strain will require surgery to treat and is also likely to result in permanent impairment.
Lumbar Spine Fracture
In some cases, work-related injuries may result in a spinal fracture, which can result in bone fragments that damage your spinal nerves. Lumbar spine fractures can be classified into:
Any lumbar fracture can lead to serious complications, including difficulty in standing, walking, using your legs or arms, and sitting. However, burst fractures are more severe as they can even cause paralysis. Spinal fracture injuries may require surgery to treat and the need for placement in home health care or assisted living facilities.
Herniated or Bulging Disc in the Lumbar Spine
A disc is positioned between each vertebra to help cushion it from trauma. With a tough covering and soft and jelly-like interior, each disc acts as a shock absorber. A human body has 24 moving vertebrae in the spine, which includes nine fused vertebrae.
If the spine is subjected to excessive pressure, like when a person is lifting a heavy object in the workplace, the disc is squeezed by the vertebrae below and above it, causing the outer part to tear. The tearing of the disc covering is known as a “rupture.”
The interior can squeeze through the torn disc covering and bulge out, a condition that is called a herniated disk. Consequently, the bulging disk may irritate, compress and even damage the spinal nerve root accompanying it, resulting in more radiating pain. A herniated disk may also require surgery to treat.
Factors that Impact the Fair Amount for a Workers Compensation Back Injury
There are several factors that determine the amount that you will receive a fair settlement for the work-related back injury. Some of the factors include:
The first step in determining the workers’ comp settlement for back injury is checking whether the medical evidence shows that your injury resulted from a work accident or it contributed to it. Consequently, the first step that a personal injury lawyer takes in a case on this kind of injury is collecting all the medical records. Here is what to look for in medical records:
- Past reports that show any sign of back pain or if the symptoms included radiating pain
- The medical histories to determine whether they describe non-work-related accidents (lifting heavy objects at home or car crashes) or work-related accidents.
- Physician statements on the cause, whether they point to a work-related accident as the cause of the injury
- Physician statements showing the severity of the injury and whether you are disabled for work or whether you are able to handle light-duty
- Signs and tests pointing to lumbar spine conditions or back pain like:
i. Testing on a range of motion
ii. Tenderness (Palpation) to touch
iii. Waddell signs
iv. Straight leg raising test
- Diagnostic imaging test results like:
a. CT (Computerized Tomography)- The test helps assess the damage on the spinal structures for stenosis or herniated disc
b. X-rays that seek to spot spinal fractures
c. Ultrasound – The imaging test helps detect tears in the ligaments, tendons, and lumbar muscles
d. Myelogram- It helps detect any sign of the compression of the spinal cord nerve root
e. Discography- The test tries to reproduce the symptoms in order to determine the origin or the causation.
Back injury Treatment
The kind of treatment required for your injury is the other important factor that determines the settlement amount in your back injury claim. Therefore, your workers’ comp settlement amount will greatly depend on whether you need just a conservative treatment or surgery.
Workers Compensation Award Order
The workers’ compensation award letter provides one of the few ways that offer injured work leverage in settlement negotiations. In most cases, the insurance company will try to deny your claim initially or accept but offer a settlement for the lumbar strain only and not the lumbar spine.
However, suppose the insurer accepts that your back injury is work-related and agrees to consider the Workers Compensation Award Order that compensates all the injured parts. This will make your case have more settlement value as it is almost impossible for the insurance company to escape the liability for the medical benefits and your wage loss.
What are the Keys to a Strong Workers Comp Case?
Usually, every employee must have compensation insurance for each employee, and the coverage is not dependent on any particular factor. This means that all the employees must be covered regardless of the duration with the company, dependents, or hours worked.
However, being covered doesn’t mean that the insurance company will offer you a payout in case of an injury. The insurer and employee may quickly agree to a given amount as a payout after your injury, but you will have to argue your case to win a fair settlement in most cases.
To win a settlement, you need to do the following:
- Present a strong and valid case that offers enough evidence that you were injured during work.
- Prove that the injury has led to damages, including restricting your ability to work.
- Make sure that every important detail is properly documented
- Make sure that all the right paperwork is done and with the specified timeline
- Collecting all the medical evidence, including medical history, tests, past reports, and tests
Do I Need to Look for a Personal Injury Lawyer?
Hiring a reliable and experienced lawyer is necessary, though not a requirement in all cases on workers comp. Settlement cases can be confusing and technical sometimes, which means that having a person who understands how things work is important.
Moreover, injured employees who hire attorneys to guide and help them through workers comp claims usually receive more payout in terms of a settlement. Securing the services of a personal injury lawyer, make sure that your claim is handled properly, allowing you to recover without major financial consequences.
- Workers’ Compensation: https://www.dol.gov/general/topic/workcomp
- Workers’ Compensation Settlements: https://www.dli.mn.gov/sites/default/files/pdf/infosheet_settlements.pdf
- Understanding Your Schedule Loss of Use Order: http://www.wcb.ny.gov/content/main/Workers/ScheduledLossUse.jsp
- Settling a Case: https://labor.mo.gov/DWC/Injured_Workers/settling_case